What is low grade depression

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Understanding Low-Grade Depression

Definition and Subtypes of Low-Grade Depression

Low-grade depression, often referred to as dysthymic disorder or dysthymia, is characterized by chronic, less severe depressive symptoms that persist for an extended period. This condition can be categorized into several subtypes based on onset age, underlying causes, and associated psychopathology. These subtypes include:

Late-Onset Primary Depressions with Residual Chronicity: These are depressions that begin later in life and persist over time.
Chronic Secondary Dysphorias: These can occur at any age and are often part of broader neurotic disorders or reactions to long-term medical conditions.
Early-Onset Characterologic Depressions: This category includes:
- Character-Spectrum Disorders: These develop due to tumultuous early relationships.
- Subaffective Dysthymic Disorders: These are considered genetically milder forms of primary affective illnesses .

Biological Markers: Low-Grade Inflammation

Recent research has highlighted the role of low-grade inflammation in depression. In particular, elevated levels of C-reactive protein (CRP) have been associated with depressive symptoms. A systematic review and meta-analysis found that approximately 27% of patients with depression exhibit low-grade inflammation (CRP >3 mg/L), and 58% show mildly elevated CRP levels (>1 mg/L). These findings suggest that inflammation is a significant factor in a substantial proportion of depressed patients .

Conclusion

Low-grade depression encompasses a range of chronic depressive conditions with varying etiologies and characteristics. Understanding these subtypes and the role of biological markers like CRP can aid in better diagnosis and treatment strategies. The presence of low-grade inflammation in many patients underscores the potential for targeted anti-inflammatory treatments in managing depression.

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Most relevant research papers on this topic

Dysthymic disorder: psychopathology of proposed chronic depressive subtypes.

Chronic depressive disorders can be divided into late-onset primary depressions, chronic secondary dysphorias, and early-onset characterologic depressions, with differences in family history, REM latency, and pharmacologic responsiveness.

Highly Cited

1983·

440citations

·H. Akiskal

The American journal of psychiatry

Prevalence of low-grade inflammation in depression: a systematic review and meta-analysis of CRP levels

Low-grade inflammation is prevalent in 27% of depression patients, and over half of them have mildly elevated CRP levels, suggesting inflammation could be relevant to a large number of patients.

Meta-AnalysisVery Rigorous JournalHighly Cited

2019·

437citations

·E. Osimoet al.

Psychological Medicine

Familial and developmental factors in characterological depressions.

Characterological depressions have lower incidence of familial depressions but higher frequencies of parental alcoholism and parental assortative mating, suggesting the DSM-III concept of 'dysthymia' is too broad.

Observational StudyHighly Cited

1981·

107citations

·Ted L. Rosenthalet al.

Journal of affective disorders

So depression is an inflammatory disease, but where does the inflammation come from?

Depression is linked to chronic low-grade inflammation and oxidative stress, with factors like psychosocial stressors, poor diet, physical inactivity, obesity, smoking, and gut issues potentially increasing the risk.

Rigorous JournalHighly Cited

2013·

1020citations

·M. Berket al.

BMC Medicine

[The intestinal microbiota: A new player in depression?]

Dysbiosis in depression patients may contribute to low grade inflammation, but the evidence supporting a causal relationship through low grade inflammation is limited and further studies are needed.

Systematic Review

2018·

3citations

·M. Meyrelet al.

L'Encephale

Low Academic Competence in First Grade as a Risk Factor for Depressive Cognitions and Symptoms in Middle School.

Low academic competence in first grade is a risk factor for depressive symptoms in middle school, with larger effects for girls.

Observational StudyHighly Cited

2008·

97citations

·K. Hermanet al.

Journal of counseling psychology

Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions

Depression is associated with 102 genetic variants and 269 genes, with prefrontal brain regions playing a key role in its development.

Meta-AnalysisVery Rigorous JournalHighly Cited

2019·

1789citations

·David Mark Howardet al.

Nature Neuroscience

Associations of low grade inflammation and endothelial dysfunction with depression – The Maastricht Study

Inflammation and endothelial dysfunction are both independently associated with depressive disorder, suggesting they may play a role in depression.

Observational StudyRigorous JournalHighly Cited

2016·

126citations

·F. V. Doorenet al.

Brain, Behavior, and Immunity

Low-Grade Inflammation as a Predictor of Antidepressant and Anti-Inflammatory Therapy Response in MDD Patients: A Systematic Review of the Literature in Combination With an Analysis of Experimental Data Collected in the EU-MOODINFLAME Consortium

Low-grade inflammation in patients with major depressive disorder predicts poor response to first-line antidepressants, suggesting a need for dopaminergic or glutamatergic regimens or anti-inflammatory agents.

Systematic ReviewHighly Cited

2019·

139citations

·Gara Arteaga-Henríquezet al.

Frontiers in Psychiatry

Low-grade inflammation and endothelial dysfunction predict four-year risk and course of depressive symptoms: The Maastricht study

Low-grade inflammation and endothelial dysfunction are both associated with the development of depressive symptoms, with endothelial dysfunction being more strongly associated with persistent symptoms.

Observational StudyRigorous Journal

2021·

20citations

·E. P. Janssenet al.

Brain, Behavior, and Immunity

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