Clinical and subsyndromal depression adversely affect physical health, relationships and cognitive performance, and produce the greatest decrement in personal health and the highest cost of care among all chronic diseases. As a result, depression has been described as the major contributor to total disease burden and continues to be the second most common contributor to years lived with a disability.
However, despite the significant burden of depression on our community, initial treatments succeed as infrequently as one-third of the time and only improve to twice that rate with additional treatments, often with significant inter-patient variability in outcomes. This variability in treatment outcomes may be the result of individual differences in patients' predictors of depression and their particular symptom profiles.
This way of understanding depression includes individual differences in genetic, psychological, biological, and environmental predisposing factors to depression, particularly following a major stressors such as PCa. Although previous depressive episodes, and physical health problems, plus psychosocial difficulties, have been identified as predictors of depression in the general community, no comprehensive research programme has been reported which examines the range of possible predictors of depression, and that is the aim of our current research projects PROFILE-D and NEMHS.
PROFILE-D is a long-term project of the Brain-Behaviour Research Group aimed at "mapping" the neurobiological profiles of depression, especially the four Clinical Content Subtypes of Depressionthat we are interested in (Depressed Mood, Anhedonia, Cognitive Depression, Somatic depression).
Data are currently being collected on:
- Neurobiological activity (EEG, HR, HRV, EDA)
- Immunological agents (IL-1B, IL-6, CRP, sTNF-RII
- Biochemical factors (HPA-axis activity, SAM axis activity)
- Psychological and Behavioural factors (Coping Strategies, Resilience).
These data are being used to form a computational model that describes the four subtypes of depression so that targeted treatment strategies may be developed.
In addition, the Brain-Behaviour Research Group is also running a large epidemiological study into depression in rural communities via the New England Mental Health Study (NEMHS). The aim of this project is to identify
- predisposing factors for depression such as
- socioeconomic/demographic factors,
- genetic factors,
- stress factors,
- inflammatory factors, and
- fatigue, as well as
- protective factors for depression, such as Coping Strategies, Psychological Resilience, Exercise, Family and Relationship Support.
This information will enable us to form a model of depression in rural communities.