Citation

Fonseca F, Mestre-Pinto JI, Rodríguez-Minguela R, Papaseit E, Pérez-Mañá C, Langohr K, Barbuti M, Farré M, Torrens M. Front. Psychiatry 2022; 13.

Copyright

(Copyright © 2022, Frontiers Media)

DOI

10.3389/fpsyt.2022.836771

PMID

unavailable

Abstract

BACKGROUND: Major depressive disorder (MDD) and cocaine use disorder (CUD) are related with disability and high mortality rates. The assessment and treatment of psychiatric comorbidity is challenging due to its high prevalence and its clinical severity, mostly due to suicide rates and the presence of medical comorbidities. The aim of this study is to investigate differences in brain derived neurotrophic factor (BDNF) and cortisol plasmatic levels in patients diagnosed with CUD-primary-MDD and CUD-induced-MDD and also to compare them to a sample of MDD patients (without cocaine use), a sample of CUD (without MDD), and a group of healthy controls (HC) after a stress challenge.

METHODS: A total of 46 subjects were included: MDD (n = 6), CUD (n = 15), CUD-primary-MDD (n = 16), CUD-induced-MDD (n = 9), and 21 HC. Psychiatric comorbidity was assessed with the Spanish version of the Psychiatric Research Interview for Substance and Mental Disorders IV (PRISM-IV), and depression severity was measured with the Hamilton Depression Rating Scale (HDRS). Patients were administered the Trier Social Stress Test (TSST) before and after the biological measures, including BDNF, and cortisol levels were obtained.

RESULTS: After the TSST, Cohen's d values between CUD-primary-MDD and CUD-induced-MDD increased in each assessment from 0.19 post-TSST to 2.04 post-90-TSST. Pairwise differences among CUD-induced-MDD and both MDD and HC groups had also a large effect size value in post-30-TSST and post-90-TSST. In the case of the BDNF concentrations, CUD-primary-MDD and CUD-induced-MDD in post-90-TSST (12,627.27 ± 5488.09 vs.17,144.84 ± 6581.06, respectively) had a large effect size (0.77).

CONCLUSION: Results suggest a different pathogenesis for CUD-induced-MDD with higher levels of cortisol and BDNF compared with CUD-primary-MDD. Such variations should imply different approaches in treatment. Copyright © 2022 Fonseca, Mestre-Pinto, Rodríguez-Minguela, Papaseit, Pérez-Mañá, Langohr, Barbuti, Farré, Torrens and NEURODEP GROUP.

Language: en

Keywords

adult; human; female; male; depression; major depression; dual diagnosis; comorbidity; cocaine; pathogenesis; major clinical study; controlled study; antidepressant agent; hydrocortisone; human cell; serotonin uptake inhibitor; family history; diagnostic accuracy; onset age; cohort analysis; heart rate; hydrocortisone blood level; cocaine dependence; Article; brain derived neurotrophic factor; diastolic blood pressure; effect size; cortisol; Hamilton Depression Rating Scale; mental disease assessment; Trier Social Stress Test; brain derived neurotrophic factor (BDNF); cocaine use disorder; Psychiatric Research Interview for Substance and Mental Disorders IV Spanish version