Changes in midbrain serotonin transporter availability in atypically depressed subjects after one year of psychotherapy.
BACKGROUND
Psychotherapy is an effective treatment method for depression, but no differences in the psychotherapy response have been found between the subtypes of depression. The effect of psychotherapy on neurotransmitter transporter functions has never been recorded in depressed subjects.


METHODS
Depressive outpatients (N=19) received psychodynamic psychotherapy for 12 months. All subjects fulfilled the DSM-IV criteria for depression, and 8 were classified as having atypical depression. The severity of depression was assessed with the 29-item Hamilton Depression Rating Scale (HAM-D-29). Midbrain serotonin transporter (SERT) and striatum dopamine transporter (DAT) densities were recorded using single photon emission computed tomography (SPECT) brain imaging with the [123I]nor-beta-CIT radioligand before and after psychotherapy.


RESULTS
Midbrain SERT density significantly increased during psychotherapy in atypicals but not in nonatypicals. There were no changes in the levels of DAT.


CONCLUSIONS
The psychotherapy-related SERT elevation of atypically depressed subjects may be due to some unknown adaptive mechanisms inducing an increase in either the levels of SERT or serotonergic nerve terminals and therefore enhancing serotonergic activity and improving mood.
Lehto
Soili M
SM
Department of Psychiatry, Kuopio University Hospital, 70210 Kuopio, Finland. Soili.Lehto@kuh.fi
Tolmunen
Tommi
T
Joensuu
Mikko
M
Saarinen
Pirjo I
PI
Valkonen-Korhonen
Minna
M
Vanninen
Ritva
R
Ahola
Pasi
P
Tiihonen
Jari
J
Kuikka
Jyrki
J
Lehtonen
Johannes
J
D000328:Adult; D000704:Analysis of Variance; D003042:Cocaine / Q000031:analogs & derivatives / Q000378:metabolism; D003342:Corpus Striatum / Q000000981:diagnostic imaging; D003863:Depression / Q000473:pathology* / Q000628:therapy*; D050483:Dopamine Plasma Membrane Transport Proteins / Q000378:metabolism; D005260:Female; D006801:Humans; D007456:Iodine Isotopes / Q000378:metabolism; D008297:Male; D008636:Mesencephalon / Q000000981:diagnostic imaging / Q000378:metabolism*; D011613:Psychotherapy / Q000379:methods*; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism*; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D050483:Dopamine Plasma Membrane Transport Proteins; D007456:Iodine Isotopes; D050486:Serotonin Plasma Membrane Transport Proteins; C069723:2beta-carbomethoxy-3beta-(4-iodophenyl)tropane; D003042:Cocaine