Stress, Inflammation, and Cellular Vulnerability during Early Stages of Affective Disorders: Biomarker Strategies and Opportunities for Prevention and Intervention.
The mood disorder prodrome is conceptualized as a symptomatic, but not yet clinically diagnosable stage of an affective disorder. Although a growing area, more focused research is needed in the pediatric population to better characterize psychopathological symptoms and biological markers that can reliably identify this very early stage in the evolution of mood disorder pathology. Such information will facilitate early prevention and intervention, which has the potential to affect a person's disease course. This review focuses on the prodromal characteristics, risk factors, and neurobiological mechanisms of mood disorders. In particular, we consider the influence of early-life stress, inflammation, and allostatic load in mediating neural mechanisms of neuroprogression. These inherently modifiable factors have known neuroadaptive and neurodegenerative implications, and consequently may provide useful biomarker targets. Identification of these factors early in the course of the disease will accordingly allow for the introduction of early interventions which augment an individual's capacity for psychological resilience through maintenance of synaptic integrity and cellular resilience. A targeted and complementary approach to boosting both psychological and physiological resilience simultaneously during the prodromal stage of mood disorder pathology has the greatest promise for optimizing the neurodevelopmental potential of those individuals at risk of disabling mood disorders.
Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia.
Adam J
AJ
Walker
Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia.
Yesul
Y
Kim
Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA.
J Blair
JB
Price
Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Engineering, Deakin University , Geelong, VIC , Australia.
Rajas P
RP
Kale
School of Psychology, Deakin University , Melbourne, VIC , Australia.
Jane A
JA
McGillivray
School of Medicine, Deakin University , Geelong, VIC , Australia ; Department of Psychiatry, University of Melbourne , Melbourne, VIC , Australia ; Orygen Youth Health Research Centre , Melbourne, VIC , Australia ; The Florey Institute of Neuroscience and Mental Health , Melbourne, VIC , Australia.
Michael
M
Berk
Department of Psychiatry and Psychology, Mayo Clinic , Rochester, MN , USA ; School of Psychology, Deakin University , Melbourne, VIC , Australia ; Department of Psychiatry, University of Minnesota , Minneapolis, MN , USA.
Susannah J
SJ
Tye
biomarker; bipolar; cellular resilience; depression; inflammation; plasticity; prodrome; stress