Safi Ullah | Contributing Writer
Persistent depression has been a complex topic amongst experts when it comes to determining the diagnosis and the characteristics among age groups.
Dr. Daniel Klein’s detailed information session held at the Academic Health Center 1 provided insight into the struggles of recurrent-persistent depression.
Daniel Klein, Ph.D., of the department of psychology at Stony Brook University, held the information session on Friday, Feb. 2.
He articulated the importance of mental health in children. He mentions the importance of cortisol, a steroid hormone produced by the adrenal glands. It plays a crucial role in the body’s response to stress, regulating a wide range of processes including metabolism, immune response, and stress responses. It’s often referred to as the “stress hormone.”
“Cortisol as many of you know, has a diurnal slope with highest levels in the morning, lowest levels in the evening. The internalizing psychopathology, particularly depression, tends to be associated with higher learning,” said Klein when discussing the fluctuations of cortisol in children of different age groups throughout the day.
“Externalizing psychopathology is associated with a blunted diurnal slope. So similar to the RN analysis (RN analysis studies RNA’s structure and function in biology, observing a copy of DNA’s structure), we assessed capabilities and have reviewed The Child Behavior Checklist at age 3 and age 9.”
Klein then talks about irritability. Irritability refers to a state of heightened sensitivity to stimuli and a reduced tolerance for frustration, leading to feelings of agitation or annoyance more easily than usual.
“This study followed 550 early adolescents from around age 14, conducting five assessments every nine months. They completed personality questionnaires, including 28 items on anger and irritability, which were analyzed through factor analysis over time,” said Klein.
Using relational aggression management, a non-physical form of bullying, to treat 550 14-year-old girls, Klein and colleagues demonstrated that irritability is caused by a variety of factors, known as equifinality, which can result in a variety of outcomes, or multifinality, as they continue to monitor their patients.
“Equifinality indicates various causes that can lead to similar emotional states, aiding in clearer emotion research by grouping experiences. Yet, this approach has struggled with depression due to its focus on singular assessments of symptoms or biology, suggesting a longitudinal study might not improve understanding,” Klein said.
Klein concludes by describing how depressive disorders can emerge from various biological and neurological pathways, leading to different depression subtypes with distinct trajectories.
A small subset of individuals with depression experience long or frequent episodes, contributing significantly to the overall burden of depression in terms of duration, functional impairment, and healthcare costs.
Their preliminary data suggest that chronic intermittent depression may be linked to lower neural signaling. While causality remains unclear, distinguishing between chronic intermittent and time-limited depression could be crucial for understanding the pathology of depression and developing targeted interventions.
From a research and public health perspective, it’s essential to focus on these distinct subgroups of depression. Doing so could enhance our understanding of depression’s physiological basis and lead to more effective and efficient treatments, ultimately informing public health strategies and policy-making.
“What’s the threshold to kind of differentiate and distinguish one disorder as opposed or as differentiable from the other? And how might that impact diagnosis and treatment?” an audience member asked.
“Evaluating mental health involves more than current symptoms; it considers potential future effects and recognizes mental health’s spectrum nature,” Klein said when asked about distinguishing mental disorders and treatment methods.
“This complicates diagnosis and treatment, highlighting the need for personalized approaches based on the duration and severity of symptoms.”