Post-awakening salivary alpha-amylase as modulator of treatment response in patients with burnout and major depression.

Pallich, Gianandrea; Fischer, Susanne; La Marca, Roberto; grosse Holtforth, Martin; Hochstrasser, Barbara (2022). Post-awakening salivary alpha-amylase as modulator of treatment response in patients with burnout and major depression. Journal of psychiatric research, 154, pp. 175-180. Elsevier 10.1016/j.jpsychires.2022.07.045

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Around 50% of patients with major depression do not respond to standard first-line treatments, such as psychotherapy and pharmacotherapy. At the same time, a subgroup exhibits altered functioning of stress-responsive bodily systems, such as the central locus coeruleus/sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Given that these systems impact arousal and cognition, it is possible that this subgroup contributes to the high rates of non-responders. Our aim was to investigate whether sympathetic and HPA axis activity modulate treatment outcomes in patients with stress-related major depression. A total of N = 74 inpatients (median age: 50, 62% male) with signs of burnout who fulfilled diagnostic criteria for major depression were recruited. Saliva samples were collected at awakening as well as 30 and 45 min later. Alpha-amylase activity and cortisol concentrations were determined before patients underwent evidence-based multimodal treatment. Non-responders were defined as patients exhibiting a <50% decrease in depression on the Beck Depression Inventory. Non-responders had significantly higher post-awakening alpha-amylase activity than responders (p = .025). In addition, alpha-amylase activity increased significantly over the course of treatment (p = .004), irrespective of responder status. Post-awakening cortisol was neither a predictor nor an indicator of treatment response. If future research confirms alpha-amylase activity as a modulator of treatment response, this may indicate a subgroup of patients with major depression which may benefit from augmentative treatments, such as heart rate variability biofeedback and/or cognitive interventions targeting high arousal.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy

UniBE Contributor:

Grosse Holtforth, Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0022-3956

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

10 Aug 2022 15:21

Last Modified:

05 Dec 2022 16:22

Publisher DOI:

10.1016/j.jpsychires.2022.07.045

PubMed ID:

35944379

Uncontrolled Keywords:

Burnout Depression Psychotherapy Salivary alpha-amylase Salivary cortisol Stress

BORIS DOI:

10.48350/171844

URI:

https://boris.unibe.ch/id/eprint/171844

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