Barcelona snapshots

Prof. Brenda W.J.H. Penninx

Brenda W.J.H. Penninx psychiatrist Netherlands Controversias Psiquiatry Barcelona
Vrije Universiteit Amsterdam, The Netherlands
Talk Medical comorbidities and affective disorders
Date Saturday, April 21st, 2018
Time 11:00 to 11:45
Table Complexities in Psychiatry: affective disorders

BIOGRAPHY

Brenda Penninx, PhD, is Professor at the department of Psychiatry of the VU University Medical Center in Amsterdam. Since 2004 she leads the Netherlands Study of Depression and Anxiety (NESDA: www.nesda.nl), a longitudinal study of the course and consequences of depressive and anxiety disorders. Dr. Penninx is currently also involved in several other (national and EU-funded) mental health cohort and intervention studies. Central themes in her research are understanding psychosocial, somatic and neurobiological risk factors and consequences of depression and anxiety disorders and how to impact on these to improve mental health. Dr. Penninx has successfully mentored >40 researchers in obtaining their PhD, and currently supervises 10 postdocs/Assistant Professors and 23 PhD students. Her resume includes more than 800 peer-reviewed publications (H-index>100), and she belongs to the highest 1% cited researchers according to Thomas Reuters. In 2016, she has been elected member of the Royal Dutch Academy of Sciences and Arts.

ABSTRACT

Depression is the most common psychiatric disorder worldwide. The burden of disease for depression goes beyond functioning and quality of life and extends to somatic health. Depression has been shown to subsequently increase the risk of, for example, cardiovascular, stroke, diabetes and obesity morbidity (Penninx et al. BMC Med 2013). On the other hand, somatic conditions have shown to contribute to the development of depression. This bidirectional link between depression and somatic health has implications for the treatment of depression.

A first important topic that will be presented is that the presence of somatic conditions could have implications for the types of depressive symptoms that are dominant in depressed persons. I will show some examples in which it is clear that depression in patients with medical comorbidities can be accompanied by a specific depressive symptom profile. This differential profile may be explained by the fact that specific pathophysiological mechanisms may be more common in persons with somatic conditions. For instance metabolic and immune-inflammatory dysregulations are partly shared among depression and medical conditions such as cardiovascular disease, diabetes and obesity. Metabolic and immune-inflammatory dysregulations have shown to be more strongly associated with neurovegetative symptoms such as hypersomnia, hyperphagia and fatigue potentially reflective of a more generally dysregulated energy balance (Lamers et al. Mol Psych 2013).

Second, presence of somatic conditions has shown to have impact on the course and treatment efficacy of standard psychiatric treatments (Gerrits M et al.Psychother Psychosom 2013). Several studies have indicated that depression in persons with somatic comorbidities is more chronic and does not respond as well to standard antidepressant treatment. This suggest that alternative treatment strategies need to be considered and evaluated. Examples are collaborative care interventions that focus on both mental and somatic health aspects and are being conducted by a mixed team of health professionals. Such interventions have shown to be more effective than standard depression treatments in depressed patients with comorbid medical comorbidities. Other strategies are those that target specifically the pathophysiological mechanisms that are shared with the somatic conditions, such as metabolic or immune-inflammatory dysregulations (see for an example Milaneschi et al. Mol Psych 2018).

Overall, in my talk I will illustrate the close connection between mental and somatic health and the consequences this has for personalized treatment in depressed patients with medical comorbidities.

REFERENCES

[PDF] Gerrits MM, van Oppen P, van Marwijk HW, van der Horst H, Penninx BW (2013). The impact of chronic somatic diseases on the course of depressive and anxiety disorders, Psychother Psychosom 2013;82:64-6.

[PDF] Lamers F, Vogelzangs N, Merikangas KR, de Jonge P, Beekman AT, Penninx BW (2013). Evidence for a differential role of HPA-axis function, inflammation and metabolic syndrome in melancholic versus atypical depression, Mol Psychiatry 2013;18:692-9.

[PDF] Milaneschi Y, Simmons WK, van Rossum EFC, Penninx BW (2013). Depression and obesity: evidence of shared biological mechanisms, Mol Psychiatry 2018; in print.

[PDF] Penninx BW, Milaneschi Y, Lamers F, Vogelzangs N. (2010). Understanding the somatic consequences of depression: biologial mechanisms and the role of depression symptom profile, BMC Med 2013;11:129.