Major depressive disorder (MDD) is a complex and heterogeneous disorder, driven by a range of genetic, environmental, biological, and psychological factors. The risk of MDD is determined by the combination of biological susceptibility and the presence of risk or protective factors in the environment. Biological factors driving MDD may include the dysregulation of the hypothalamic–pituitary–adrenal axis, as well as the immune and inflammatory systems, and the gut microbiota, as well as structural and functional alterations of the brain.

Behavioural, psychological, or sociocultural factors also play a role in the development of depression; high socioeconomic status, social support, and equality are all protective factors reducing the risk of depression. The effect of risk or protective factors may be specific to a particular context or time, and any one specific risk or protective factor accounts for only a small proportion of MDD risk, as these factors are generally not specific to MDD.

This slide deck covers the neurobiology and aetiology of MDD, providing an overview of how these factors contribute to its development. It discusses findings from genome-wide association studies (GWAS), the role of inflammation, the impact of epigenetics, and brain changes observed in individuals with MDD.

This slide deck was developed by Professor Dr. Elisabeth Binder, Max Planck Institute of Psychiatry, Munich, Germany; and Professor Dr. Lakshmi Yatham, Department of Psychiatry, University of British Columbia, Canada, in collaboration with Cambridge (a division of Prime, Cambridge, UK).

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Major depressive disorder (MDD) - Neurobiology and aetiology

Major depressive disorder (MDD) - Neurobiology and aetiology
Major depressive disorder (MDD) - Neurobiology and aetiology
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The aetiology of depression
The aetiology of depression

Apart from the factors and mechanisms outlined on the slide, the onset and continuity of MDD are also influenced by:1

  • Epigenetic mechanisms, which might mediate gene-environment interactions
  • Alterations in brain structures and function, particularly in the pre-frontal co…
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Major depressive disorder is complex and heterogeneous
Major depressive disorder is complex and heterogeneous

The risk of major depressive disorder (MDD) is determined by the combination of biological susceptibility and the risk or protective factors present in the environment.1 The effect of risk or protective factors may be specific to a particular context or time, and any one …

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Studying the aetiology of depression

Studying the aetiology of depression
Studying the aetiology of depression
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Animal models to study depression and antidepressants
Animal models to study depression and antidepressants

Animal (e.g., mice) models to study depression (typically the forced swim test [FST], the tail suspension test [TST] and the sucrose preference test) are mostly based on the induction of biological or behavioural changes seen in people with MDD using a psychosocial or bio…

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Gene–environment interactions
Gene–environment interactions

Discrete time-limited pulses of neural gene expression in response to immediate experiences are called the genomic action potential (the gAP).2 The gAP affects the proteins, RNA, and chromatin structure in the cells of the nervous system, thus influencing how the cells wi…

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Deep phenotyping towards precision psychiatry
Deep phenotyping towards precision psychiatry

Clinically relevant markers that could help guide treatment decision-making in first-episode of major depressive disorder (MDD) continue to be scarce.1 The discovery of new treatments and patient care optimization is further complicated by the heterogeneity of MDD disease…

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Pathological hypotheses and mechanisms of depression

Pathological hypotheses and mechanisms of depression
Pathological hypotheses and mechanisms of depression
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The genetics of depression
The genetics of depression

Since 2013, genome-wide association studies (GWAS) have provided significant insight into the mechanisms underlying major depressive disorder (MDD) and its genetic risk factors.5 They have estimated the single nucleotide polymorphism (SNP)-based heritability of MDD to be …

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Genes involved in depression
Genes involved in depression

The identification of genes implicated in the development of MDD is key for elucidating the mechanisms linking genetic variation to MDD, and for finding new treatment targets in people with MDD.3 However, the complex associations of the molecular pathways determining ment…

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Environmental risk and protective factors for depression
Environmental risk and protective factors for depression

While some risk and protective factors directly affect the pathophysiological processes of major depressive disorder (MDD), their interpretation is not straightforward.1 Moreover, the relationship of many of them with MDD is bidirectional: for example, low socioeconomic s…

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Environmental factors underlying depression
Environmental factors underlying depression

Apart from the environmental factors outlined on the slide, deficiencies in nutrients such as protein, B vitamins, vitamin D, magnesium, zinc, selenium, iron, calcium, and omega-3 fatty acids may also influence the risk of developing depressive symptoms; however, addition…

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Biological factors driving depression
Biological factors driving depression

Inflammatory dysregulation may be an important factor driving major depressive disorder (MDD). A large meta-analysis showed increased levels of pro-inflammatory markers (e.g., interleukin-6 [IL-6], tumour necrosis factor-ɑ and C-reactive protein [CRP]) and reduced levels …

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Genetic and environmental drivers of behaviour
Genetic and environmental drivers of behaviour

Decision-making is a complex process; additional translational research is required to elucidate the network and connectivity characteristics of identified variations in neural substrates, and the molecular underpinnings of these variations.1 Potential molecular factors i…

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