A Delphi-method-based consensus for clinical domains and assessment of the inflammatory subtype of major depressive disorder from the ASPIRE study.
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Vai Benedetta, Cazzella Tommaso, Monopoli Camilla, Bravi Beatrice, Kontogianni Anastasia, Wessa Celine, Worrell Courtney, Simon Maria S, Baune Bernhard T, Benedetti Francesco, Cattaneo Annamaria, Van der Eycken Erik, Felger Jennifer C, Gold Stefan M, Harrison Neil A, Hoffman Nadia, Lamers Femke, Leboyer Marion, Lombardo Giulia, Mäntylä Fanni-Laura, Miller Andrew H, Mondelli Valeria, Penninx Brenda W J H, Stein Dan, Sforzini Luca, Bavato Francesco, Berk Michael, Borsini Alessandra, Branchi Igor, Capuron Lucile, Caso Javier R, Cunningham Janet L, Fusar-Poli Paolo, Haarman Bartholomeus C M, Lengvenyte Aiste, Osimo Emanuele F, Otte Christian, Pollak Thomas A, Steen Nils Eiel, Pariante Carmine M, ASPIRE Study Consortium, Picker Livia De
Аннотация
METHODS: Using a Delphi approach, international experts from the ASPIRE consortium (Advanced Stratification of People with Depression based on Inflammation, n = 25) identified ISMDD symptom domains, which were then evaluated by the European College of Neuropsychopharmacology Immuno-Neuropsychiatry Network (INPN-ECNP, n = 12). Using the same consensus structure, the coverage of these domains by depression rating scales was then assessed. People with lived experience (PWLE, n = 11) provided perspectives on the clinical relevance and impact of the emerged symptoms.
RESULTS: ASPIRE consensus identified ten ISMDD symptom domains: fatigue/low energy, hypersomnia, increased weight/appetite, cognitive difficulties, lack of motivation, anhedonia, diminished interest, leaden paralysis, psychomotor retardation, and insomnia, with the first five being also confirmed by INPN-ECNP consensus. Except for increased weight/appetite, PWLE identified these domains as negatively affecting quality of life; most of them were also reported as not extensively assessed in clinical care. Among rating scales, the Inventory of Depressive Symptomatology tools, including their Quick versions, were the only instruments covering all or almost all the ISMDD domains.
CONCLUSION: These findings support a framework for ISMDD and highlight the importance of symptom assessment to improve clinical evaluation, research, and personalized immunopsychiatric treatment.