Background
Major depressive disorder (MDD), panic disorder, and social anxiety disorder are among
the most prevalent and frequently co-occurring psychiatric disorders in adults and
may be characterized by a common deficiency in processing of emotional information.
Methods
We used functional magnetic resonance imaging during the performance of an emotional
word encoding and recognition paradigm in patients with MDD (n = 51), comorbid MDD and anxiety (n = 59), panic disorder and/or social anxiety disorder without comorbid MDD (n = 56), and control subjects (n = 49). In addition, we studied effects of illness severity, regional brain volume,
and antidepressant use.
Results
Patients with MDD, prevalent anxiety disorders, or both showed a common hyporesponse
in the right hippocampus during positive (>neutral) word encoding compared with control
subjects. During negative encoding, increased insular activation was observed in both
depressed groups (MDD and MDD + anxiety), whereas increased amygdala and anterior
cingulate cortex activation during positive word encoding were observed as depressive
state-dependent effects in MDD only. During recognition, anxiety patients showed increased
inferior frontal gyrus activation. Overall, effects were unaffected by medication
use and regional brain volume.
Conclusions
Hippocampal blunting during positive word encoding is a generic effect in depression
and anxiety disorders, which may constitute a common vulnerability factor. Increased
insular and amygdalar involvement during negative word encoding may underlie heightened
experience of, and an inability to disengage from, negative emotions in depressive
disorders. Our results emphasize a common neurobiological deficiency in both MDD and
anxiety disorders, which may mark a general insensitiveness to positive information.
Key Words
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Article info
Publication history
Published online: December 30, 2011
Accepted:
November 21,
2011
Received in revised form:
November 17,
2011
Received:
June 22,
2011
Footnotes
Authors M-JvT and LRD contributed equally to this work.
Identification
Copyright
© 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
