Science seeks new methods to combat depression: early detection of risks and individualized treatments

Depression is a chronic disease that is characterized by a persistent low mood and those who suffer from it, after suffering a first episode that comes to alter their daily lives, often have relapses.

Nearly half of people who have gone through depression suffer from it more than once.

For many patients, this condition is with them for life.

In the European Union alone, 7.2% of the population suffers from chronic depression and, in the case of women, the risk is multiplied by four.

As the medical and scientific community works to keep this global epidemic under control, one of the ideas that is gaining more strength is to detect those who are at risk of depression early, since this protects their future mental health. .

“It is becoming increasingly clear that a first episode of depression is the trigger for a second episode, so from a scientific point of view, there is a chance that preventing the first episode will prevent the next one,” explains Eiko. Fried, Associate Professor of Psychology at Leiden University in the Netherlands.

He is also the Principal Investigator of WARN-D, an EU-funded project with the aim of predicting who is at risk of “falling down the well” and then creating a custom program to avoid it.

The project started in 2021 and will run until 2026.

first symptoms

Although prevention programs already exist, including psychological interventions aimed at building resilience, these can only work when the risk of suffering a depressive episode is identified early.

WARN-D is the first study trying to develop a reliable early warning system.

It will consist of an application for smartphones capable of monitoring a user's mental health in real time and combining this information with data from their social, psychological and biological environment.

The objective is to detect the moment in which the person is reaching their personal limit, that is, the critical moment in which an accumulation of problems puts them at risk of collapsing.

The development of the application will begin in the next two years.

First, the research team has to sift through vast amounts of data looking for common traits among people prone to depression.

Its goal is to group people according to a complex set of traits, including personality (extrovert vs. introvert, for example), factors that have catalyzed the development of their disorder (such as a traumatic childhood), and a person's innate ability. person to bounce back from setbacks (also known as resilience).

Different groups are not likely to respond to the same intervention, which means that the preventive program must be tailored to each group for positive results.

youth at risk

The study sample is 2,000 young adult students (recruited in successive groups of 500), residing in the Netherlands.

People in this demographic are disproportionately affected by depression and are therefore of particular interest to the research community.

“Suffering from depression at a young age is associated with poorer clinical outcomes throughout life,” says Fried.

“Many young people will spend more than 20% of their lives in a state of depression.”

Another advantage of selecting young students is that it is easier to convince them (with the help of a cash incentive of up to 90 euros) to wear a smartwatch day and night for the first three months of the study, which will last two years.

The watch records activity, from steps taken to hours of sleep, and detects stress levels through a heart rate sensor.

In addition, four times a day they are asked questions about aspects related to how they are at that moment and that are believed to influence depression.

The questions can be about how they slept, how happy or angry they are, or what they are doing at that precise moment.

In addition, each Sunday they are asked more general questions about anxiety and depression;

for example, about what have been the best and worst events of the week.

More information

Why are we getting more and more depressed?

"Our big goal is to find out what differences exist between people in relation to their response to stress and how they are similar," says Fried.

“Once we find commonalities, we can start working on systems that make people more resilient.”

Why this sadness?

Symptoms of depression range from intense sadness, tiredness, and trouble thinking to sleep disturbances, loss of appetite, and lack of interest in previously pleasurable activities.

Almost certainly, the causes of this disease are due to the interaction of many factors, some biological and others environmental.

Genes may also play a role to some extent, as a person is more likely to develop depression if someone in their family has also had it.

However, everyone can fall into depression.

Potential triggers include stress, poverty, illness, hormonal changes, and traumatic events, such as a difficult childhood or bereavement.

Although some studies show that drugs can help, right now, the effectiveness of antidepressants is usually a matter of chance, since only half of patients respond positively to their first prescription.

Getting the medication right from the start would have a very positive effect both on people with depression and on the economy, and would ease the pressure on medical professionals.

Talia Cohen Solal is a neuroscientist and CEO of Genetika+, an Israeli company that develops tools to create personalized treatments for depression.

“Currently, our strategy for finding the right medication is trial and error,” she explains.

"As a result, 63% of patients try multiple drugs and a third do not respond to treatment after two rounds."

Brain in a petri dish

In his EU-funded RxMine project, Cohen Solal uses a “brain in a petri dish” model (in the laboratory, using stem cell technology, human stem cells and brain networks are generated from blood samples of patients) to determine the optimal antidepressant for each patient.

In previous research, the researcher's team discovered specific cellular changes called "biomarkers" in brain tissue that are related to a patient's responsiveness to a given drug.

For a person to respond positively to an antidepressant, sufficient changes in the levels of the corresponding biomarkers must be found in the generated brain models.

Research staff dream that one day all people with depression will be tested to determine which drug is best suited for them.

This could reduce depression-related healthcare costs by 43%, leading to annual savings of up to €6,500 per patient.

The team is expanding its studies with new drugs, while also working on ways to streamline its testing procedures.

“We hope to have something that we can get up and running within two years,” says Cohen Solal.

"Our main aspiration is to try to quickly find the right treatment for each patient and that they do not have to go through the unacceptable and dangerous process of trial and error to find their medication."

The research described in this article has been supported by EU funds.

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