title: Baseline symptom severity predicts serotonin transporter change during psychotherapy in patients with major depression.
abstract: OBJECTIVE
  The role of the serotonin transporter (SERT) in the pathophysiology of depression is unclear and only a few follow-up studies exist. Our aim was to measure changes in SERT availability during psychodynamic psychotherapy in patients with major depression over a follow-up time of 12 or 18 months.
  
  
  METHODS
  The patients were studied with iodine-123 labelled 2β-carbomethoxy-3β-(4-iodophenyl) serial single-photon emission tomography imaging and clinical rating scales of symptoms.
  
  
  RESULTS
  Changes in SERT availability had no correlation with the change of symptoms, but the change of SERT availability during psychotherapy in the midbrain was predicted by the baseline severity of the clinical symptoms measured by the Symptom Checklist Depression Scale and the Symptom Checklist Global Severity Index. With cut-off values applied, it was found that SERT availabilities increased in patients with high baseline symptoms, and decreased in patients with low baseline symptoms.
  
  
  CONCLUSIONS
  Together with our earlier finding of decreased SERT in patients with depression, these results indicate a state-dependent and possibly a compensatory role of decreased SERT availability in depression.
authors: Department of Forensic Psychiatry, University of Eastern Finland, Kuopio, Finland.
authors: Mikko
authors: M
authors: Joensuu
authors: University of Eastern Finland, Kuopio, Finland.|Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
authors: Pasi
authors: P
authors: Ahola
authors: National Institute for Health and Welfare, Helsinki, Finland.
authors: Paul
authors: P
authors: Knekt
authors: National Institute for Health and Welfare, Helsinki, Finland.
authors: Olavi
authors: O
authors: Lindfors
authors: Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.|Kuopio Psychiatric Center, Kuopio, Finland.
authors: Pirjo
authors: P
authors: Saarinen
authors: Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
authors: Tommi
authors: T
authors: Tolmunen
authors: University of Eastern Finland, Kuopio, Finland.|Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
authors: Minna
authors: M
authors: Valkonen-Korhonen
authors: Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.
authors: Ritva
authors: R
authors: Vanninen
authors: National Institute for Health and Welfare, Helsinki, Finland.
authors: Tuija
authors: T
authors: Jääskeläinen
authors: National Institute for Health and Welfare, Helsinki, Finland.
authors: Esa
authors: E
authors: Virtala
authors: Department of Clinical Physiology and Nuclear Medicine, University of Kuopio, Kuopio, Finland.
authors: Jyrki
authors: J
authors: Kuikka
authors: Department of Forensic Psychiatry, University of Eastern Finland, Kuopio, Finland.|National Institute for Health and Welfare, Helsinki, Finland.|Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
authors: Jari
authors: J
authors: Tiihonen
authors: Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.|National Institute for Health and Welfare, Helsinki, Finland.
authors: Johannes
authors: J
authors: Lehtonen
mesh_terms: D000328:Adult; D003042:Cocaine / Q000031:analogs & derivatives / Q000378:metabolism; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000378:metabolism* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000378:metabolism; D008297:Male; D008636:Mesencephalon / Q000187:drug effects / Q000378:metabolism; D059906:Neuroimaging; D064889:Psychotherapy, Psychodynamic; D011869:Radioligand Assay; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism*; D012720:Severity of Illness Index; D015899:Tomography, Emission-Computed, Single-Photon; D055815:Young Adult
chemical_list: C528135:2-carbomethoxy-3-(3'-iodophenyl)tropane; D007457:Iodine Radioisotopes; D050486:Serotonin Plasma Membrane Transport Proteins; D003042:Cocaine
keywords: follow-up; midbrain; psychodynamic psychotherapy; serial single-photon emission tomography; serotonin transporter