Possibilities of using laboratory biomarkers for the objective diagnosis of depressive disorders

 Objective: to assess the possibility of using laboratory biomarkers to objectify psychopathological disorders in patients with depressive spectrum disorders (RSDs).

Patients and methods. The investigation enrolled 63 patients (mean age, 31.7±8.9 years) with new-onset RSDs of different etiologies. Group 1 included 21 patients with a mild to moderate depressive episode (DE); Group 2 consisted of 42 patients with neurotic depressive disorders (adjustment disorders). The severity of anxiety and depression was assessed using the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, and the Hospital Anxiety and Depression Scale. In addition, the investigators studied laboratory  parameters: the levels of cortisol, homocysteine, prolactin,  vitamin B12, cortisol, interleukin (IL)-1β, IL-6, and tumor necrosis  factor-α (TNF-α) in serum and platelet serotonin. They  also estimated changes in the most significant laboratory  parameters in 31 patients with depressive disorders: in 15 with  DE and in 16 with neurotic depression who had received 4-week monotherapy with agomelatine 25 mg/day.

Results and discussion. The differential diagnosis of  psychopathological disorders based on the clinical and  psychopathological method and psychometric assessment of  the patient's condition was shown to be difficult. It was  established that the objectification of these disorders using  known laboratory biomarkers (cortisol and platelet serotonin) did not give an unambiguous answer. At the same time, the  assessment of immunological parameters (the levels of  proinflammatory cytokines, such as IL-6, TNF-α) can help to  solve this problem. The investigation also demonstrated that the use of non-monoaminergic antidepressants (MT1/MT2-type  melatonin receptor agonists) contributed to the reduced level of proinflammatory cytokines, which opens up  opportunities for finding new therapeutic approaches to  treating RSDs. 

Conclusion. Usage of biological markers may contribute not only to improvement in the accuracy of mental disorders  diagnosis but also to the development of new treatment approaches. Simultaneously, the selective use of individual biological markers (biochemical, metabolic, immunological, etc.)  is not very informative; therefore, their comprehensive  assessment is required.  

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