A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression

Zuzanna Zajkowska; Annabel Walsh; Valentina Zonca; Nancy Gullett; Gloria A. Pedersen; Christian Kieling; Johnna R. Swartz; Rakesh Karmacharya; Helen Fisher; Brandon A Kohrt; Valeria Mondelli

doi:10.1016/j.jpsychires.2021.04.003

A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression

Zuzanna Zajkowska, Annabel Walsh, Valentina Zonca, Nancy Gullett, Gloria A. Pedersen, Christian Kieling, Johnna R. Swartz, Rakesh Karmacharya, Helen Fisher, Brandon A Kohrt, Valeria Mondelli

Research output: Contribution to journal › Review article › peer-review

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Abstract

Introduction: Although the aetiology and pathophysiology of depression are multifactorial, to date most studies have examined either biological or environmental mechanisms without looking at the integration of both; with most studies conducted in high-income countries (HICs). Therefore, we conducted a systematic review of worldwide studies investigating the relationship between biological and environmental stress risk factors for major depressive disorder (MDD) in adolescence. Methods: We searched MEDLINE (via Ovid), PsycINFO, Cochrane Database of Systematic Reviews, Web of Science (Core Collection), Lilacs, African Journals Online and Global Health for prospective and cross-sectional studies that examined the association between biological markers and environmental stress risk factors in MDD during adolescence. Findings: Of 11,089 articles identified, 21 were included, with only two from middle-income countries. Increased inflammation, telomere length and brain abnormalities, including blunted reward-related activity, white matter disruptions, and altered volume of limbic brain regions, were associated with increased risk for MDD mainly in the context of early life adversity. There is little evidence suggesting that the neurobiological changes investigated were associated with MDD in the context of recent life stress. Interpretation: The developmental trajectory of depression appears to start with early life adversities and occurs in the context of immune and brain abnormalities. Understanding these biopsychosocial processes will help to improve our ability to detect individuals at risk of developing depression in adolescence. However, generalizability is limited by few studies examining both biological and environmental stress risk factors and a lack of studies on adolescents and young adults in low-and-middle-income countries (LMICs).

Original language	English
Pages (from-to)	163-175
Number of pages	13
Journal	Journal of Psychiatric Research
Volume	138
Early online date	7 Apr 2021
DOIs	https://doi.org/10.1016/j.jpsychires.2021.04.003
Publication status	Published - Jun 2021

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Zajkowska, Z., Walsh, A., Zonca, V., Gullett, N., Pedersen, G. A., Kieling, C., Swartz, J. R., Karmacharya, R., Fisher, H., Kohrt, B. A., & Mondelli, V. (2021). A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression. Journal of Psychiatric Research, 138, 163-175. https://doi.org/10.1016/j.jpsychires.2021.04.003

@article{ce64fabb5c0243f49f148a60fabbc84a,

title = "A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression",

abstract = "Introduction: Although the aetiology and pathophysiology of depression are multifactorial, to date most studies have examined either biological or environmental mechanisms without looking at the integration of both; with most studies conducted in high-income countries (HICs). Therefore, we conducted a systematic review of worldwide studies investigating the relationship between biological and environmental stress risk factors for major depressive disorder (MDD) in adolescence. Methods: We searched MEDLINE (via Ovid), PsycINFO, Cochrane Database of Systematic Reviews, Web of Science (Core Collection), Lilacs, African Journals Online and Global Health for prospective and cross-sectional studies that examined the association between biological markers and environmental stress risk factors in MDD during adolescence. Findings: Of 11,089 articles identified, 21 were included, with only two from middle-income countries. Increased inflammation, telomere length and brain abnormalities, including blunted reward-related activity, white matter disruptions, and altered volume of limbic brain regions, were associated with increased risk for MDD mainly in the context of early life adversity. There is little evidence suggesting that the neurobiological changes investigated were associated with MDD in the context of recent life stress. Interpretation: The developmental trajectory of depression appears to start with early life adversities and occurs in the context of immune and brain abnormalities. Understanding these biopsychosocial processes will help to improve our ability to detect individuals at risk of developing depression in adolescence. However, generalizability is limited by few studies examining both biological and environmental stress risk factors and a lack of studies on adolescents and young adults in low-and-middle-income countries (LMICs).",

author = "Zuzanna Zajkowska and Annabel Walsh and Valentina Zonca and Nancy Gullett and Pedersen, {Gloria A.} and Christian Kieling and Swartz, {Johnna R.} and Rakesh Karmacharya and Helen Fisher and Kohrt, {Brandon A} and Valeria Mondelli",

note = "Funding Information: This research was funded by the MQ Transforming Mental Health Charity, Brighter Futures grant named ?Identification of Depression Early in Adolescence? [MQBF/1 IDEA]. Additional support was provided by the UK Medical Research Council [MC_PC_MR/R019460/1] and the Academy of Medical Sciences [GCRFNG\100281] under the Global Challenges Research Fund. CK has received support from Brazilian governmental research funding agencies (Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico [CNPq], Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior [CAPES], and Funda??o de Amparo ? Pesquisa do Estado do Rio Grande do Sul [Fapergs]) and is an Academy of Medical Sciences Newton Advanced Fellow. VM is supported by the Medical Research Foundation [MRF-160-0005-ELP-MONDE] and by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. HLF receives salary support from the Economic and Social Research Council (ESRC) Centre for Society and Mental Health at King's College London [ES/S012567/1]. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health and Social Care, the ESRC, or King's College London. BAK received support from the US National Institute of Mental Health [K01MH104310, R21MH111280]. RK received support from the US National Institute of Mental Health [K08MH086846, R01MH113858]. Funding Information: This research was funded by the MQ Transforming Mental Health Charity, Brighter Futures grant named “Identification of Depression Early in Adolescence” [MQBF/1 IDEA]. Additional support was provided by the UK Medical Research Council [ MC_PC_MR/R019460/1 ] and the Academy of Medical Sciences [ GCRFNG\100281 ] under the Global Challenges Research Fund. CK has received support from Brazilian governmental research funding agencies ( Conselho Nacional de Desenvolvimento Cient{\'i}fico e Tecnol{\'o}gico [CNPq] , Coordena{\c c}{\~a}o de Aperfei{\c c}oamento de Pessoal de N{\'i}vel Superior [CAPES] , and Funda{\c c}{\~a}o de Amparo {\`a} Pesquisa do Estado do Rio Grande do Sul [Fapergs] ) and is an Academy of Medical Sciences Newton Advanced Fellow. VM is supported by the Medical Research Foundation [ MRF-160-0005-ELP-MONDE ] and by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. HLF receives salary support from the Economic and Social Research Council (ESRC) Centre for Society and Mental Health at King's College London [ ES/S012567/1 ]. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health and Social Care, the ESRC, or King's College London. BAK received support from the US National Institute of Mental Health [ K01MH104310 , R21MH111280 ]. RK received support from the US National Institute of Mental Health [ K08MH086846 , R01MH113858 ]. Publisher Copyright: {\textcopyright} 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = jun,

doi = "10.1016/j.jpsychires.2021.04.003",

language = "English",

volume = "138",

pages = "163--175",

journal = "Journal of Psychiatric Research",

issn = "0022-3956",

publisher = "Elsevier",

}

Zajkowska, Z , Walsh, A , Zonca, V , Gullett, N, Pedersen, GA, Kieling, C, Swartz, JR, Karmacharya, R, Fisher, H, Kohrt, BA & Mondelli, V 2021, 'A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression', Journal of Psychiatric Research, vol. 138, pp. 163-175. https://doi.org/10.1016/j.jpsychires.2021.04.003

TY - JOUR

T1 - A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression

AU - Zajkowska, Zuzanna

AU - Walsh, Annabel

AU - Zonca, Valentina

AU - Gullett, Nancy

AU - Pedersen, Gloria A.

AU - Kieling, Christian

AU - Swartz, Johnna R.

AU - Karmacharya, Rakesh

AU - Fisher, Helen

AU - Kohrt, Brandon A

AU - Mondelli, Valeria

N1 - Funding Information: This research was funded by the MQ Transforming Mental Health Charity, Brighter Futures grant named ?Identification of Depression Early in Adolescence? [MQBF/1 IDEA]. Additional support was provided by the UK Medical Research Council [MC_PC_MR/R019460/1] and the Academy of Medical Sciences [GCRFNG\100281] under the Global Challenges Research Fund. CK has received support from Brazilian governmental research funding agencies (Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico [CNPq], Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior [CAPES], and Funda??o de Amparo ? Pesquisa do Estado do Rio Grande do Sul [Fapergs]) and is an Academy of Medical Sciences Newton Advanced Fellow. VM is supported by the Medical Research Foundation [MRF-160-0005-ELP-MONDE] and by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. HLF receives salary support from the Economic and Social Research Council (ESRC) Centre for Society and Mental Health at King's College London [ES/S012567/1]. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health and Social Care, the ESRC, or King's College London. BAK received support from the US National Institute of Mental Health [K01MH104310, R21MH111280]. RK received support from the US National Institute of Mental Health [K08MH086846, R01MH113858]. Funding Information: This research was funded by the MQ Transforming Mental Health Charity, Brighter Futures grant named “Identification of Depression Early in Adolescence” [MQBF/1 IDEA]. Additional support was provided by the UK Medical Research Council [ MC_PC_MR/R019460/1 ] and the Academy of Medical Sciences [ GCRFNG\100281 ] under the Global Challenges Research Fund. CK has received support from Brazilian governmental research funding agencies ( Conselho Nacional de Desenvolvimento Científico e Tecnológico [CNPq] , Coordenação de Aperfeiçoamento de Pessoal de Nível Superior [CAPES] , and Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul [Fapergs] ) and is an Academy of Medical Sciences Newton Advanced Fellow. VM is supported by the Medical Research Foundation [ MRF-160-0005-ELP-MONDE ] and by the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. HLF receives salary support from the Economic and Social Research Council (ESRC) Centre for Society and Mental Health at King's College London [ ES/S012567/1 ]. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR, the Department of Health and Social Care, the ESRC, or King's College London. BAK received support from the US National Institute of Mental Health [ K01MH104310 , R21MH111280 ]. RK received support from the US National Institute of Mental Health [ K08MH086846 , R01MH113858 ]. Publisher Copyright: © 2021 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/6

Y1 - 2021/6

N2 - Introduction: Although the aetiology and pathophysiology of depression are multifactorial, to date most studies have examined either biological or environmental mechanisms without looking at the integration of both; with most studies conducted in high-income countries (HICs). Therefore, we conducted a systematic review of worldwide studies investigating the relationship between biological and environmental stress risk factors for major depressive disorder (MDD) in adolescence. Methods: We searched MEDLINE (via Ovid), PsycINFO, Cochrane Database of Systematic Reviews, Web of Science (Core Collection), Lilacs, African Journals Online and Global Health for prospective and cross-sectional studies that examined the association between biological markers and environmental stress risk factors in MDD during adolescence. Findings: Of 11,089 articles identified, 21 were included, with only two from middle-income countries. Increased inflammation, telomere length and brain abnormalities, including blunted reward-related activity, white matter disruptions, and altered volume of limbic brain regions, were associated with increased risk for MDD mainly in the context of early life adversity. There is little evidence suggesting that the neurobiological changes investigated were associated with MDD in the context of recent life stress. Interpretation: The developmental trajectory of depression appears to start with early life adversities and occurs in the context of immune and brain abnormalities. Understanding these biopsychosocial processes will help to improve our ability to detect individuals at risk of developing depression in adolescence. However, generalizability is limited by few studies examining both biological and environmental stress risk factors and a lack of studies on adolescents and young adults in low-and-middle-income countries (LMICs).

AB - Introduction: Although the aetiology and pathophysiology of depression are multifactorial, to date most studies have examined either biological or environmental mechanisms without looking at the integration of both; with most studies conducted in high-income countries (HICs). Therefore, we conducted a systematic review of worldwide studies investigating the relationship between biological and environmental stress risk factors for major depressive disorder (MDD) in adolescence. Methods: We searched MEDLINE (via Ovid), PsycINFO, Cochrane Database of Systematic Reviews, Web of Science (Core Collection), Lilacs, African Journals Online and Global Health for prospective and cross-sectional studies that examined the association between biological markers and environmental stress risk factors in MDD during adolescence. Findings: Of 11,089 articles identified, 21 were included, with only two from middle-income countries. Increased inflammation, telomere length and brain abnormalities, including blunted reward-related activity, white matter disruptions, and altered volume of limbic brain regions, were associated with increased risk for MDD mainly in the context of early life adversity. There is little evidence suggesting that the neurobiological changes investigated were associated with MDD in the context of recent life stress. Interpretation: The developmental trajectory of depression appears to start with early life adversities and occurs in the context of immune and brain abnormalities. Understanding these biopsychosocial processes will help to improve our ability to detect individuals at risk of developing depression in adolescence. However, generalizability is limited by few studies examining both biological and environmental stress risk factors and a lack of studies on adolescents and young adults in low-and-middle-income countries (LMICs).

UR - http://www.scopus.com/inward/record.url?scp=85103979558&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychires.2021.04.003

DO - 10.1016/j.jpsychires.2021.04.003

M3 - Review article

SN - 0022-3956

VL - 138

SP - 163

EP - 175

JO - Journal of Psychiatric Research

JF - Journal of Psychiatric Research

ER -

A systematic review of the association between biological markers and environmental stress risk factors for adolescent depression

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