Velásquez María Marcela, Gómez-Maquet Yvonne, Ferro Eugenio, Cárdenas Wilmer, González-Nieves Silvia, Lattig María Claudia
Centro de Investigaciones Genéticas en Enfermedades Humanas, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia.
Departamento de Psicología, Universidad de los Andes, Bogotá, Colombia.
Front Psychiatry. 2021 Dec 14;12:768680. doi: 10.3389/fpsyt.2021.768680. eCollection 2021.
Major Depression is a complex disorder with a growing incidence worldwide and multiple variables have been associated with its etiology. Nonetheless, its diagnosis is continually changing and the need to understand it from a multidimensional perspective is clear. The purpose of this study was to identify risk factors for depression in a case-control study with 100 depressive inpatients and 87 healthy controls. A multivariate logistic regression analysis was performed including psychosocial factors, cognitive maladaptive schema domains, and specific epigenetic marks (BDNF methylation levels at five CpG sites in promoter IV). A family history of depression, the cognitive schemas of impaired autonomy/performance, impaired limits, other-directedness, and the methylation level of a specific CpG site were identified as predictors. Interestingly, we found a mediating effect of those cognitive schemas in the relationship between childhood maltreatment and depression. Also, we found that depressive patients exhibited hypomethylation in a CpG site of BDNF promoter IV, which adds to the current discussion about the role of methylation in depression. We highlight that determining the methylation of a specific region of a single gene offers the possibility of accessing a highly informative an easily measurable variable, which represents benefits for diagnosis. Following complete replication and validation on larger samples, models like ours could be applicable as additional diagnostic tools in the clinical context.
重度抑郁症是一种复杂的疾病,在全球范围内发病率不断上升,其病因与多个变量相关。尽管如此,其诊断标准不断变化,从多维角度理解该疾病的必要性显而易见。本研究的目的是在一项病例对照研究中确定抑郁症的危险因素,该研究纳入了100名抑郁症住院患者和87名健康对照者。进行了多因素逻辑回归分析,纳入了社会心理因素、认知适应不良图式领域和特定的表观遗传标记(启动子IV中五个CpG位点的BDNF甲基化水平)。抑郁症家族史、自主性/表现受损、界限受损、他人导向的认知图式以及特定CpG位点的甲基化水平被确定为预测因素。有趣的是,我们发现这些认知图式在童年虐待与抑郁症之间的关系中起中介作用。此外,我们发现抑郁症患者在BDNF启动子IV的一个CpG位点表现出低甲基化,这为当前关于甲基化在抑郁症中的作用的讨论增添了内容。我们强调,确定单个基因特定区域的甲基化提供了获取一个信息丰富且易于测量的变量的可能性,这对诊断具有益处。在更大样本上进行完全复制和验证后,像我们这样的模型可作为临床环境中的额外诊断工具应用。