Biological Markers to Differentiate the Subtypes of Depression

  • Je-Yeon Yun
  • Seung-Hwan LeeEmail author


Patients with major depressive disorder (MDD) are heterogeneous in terms of the dominant symptom characteristics, degrees of disability in daily life, course of illness, and response to pharmacotherapy. It is assumed that this heterogeneity stems from different biological mechanisms per MDD subtype. Based on this, MDD has been clinically classified into melancholic [characterized by the presence of psychomotor disturbance and strong relationship with symptom domains such as feelings of guilt, anhedonia, psychic anxiety, and tiredness/pain], atypical [defined as presence of mood reactivity in addition to some of the following symptoms: increased appetite/weight gain, hypersomnia, leaden paralysis, and/or sensitivity to interpersonal rejection], and psychotic [distinguished from MDD melancholic subtype by presence of psychotic features including delusions and/or hallucinations] subtypes. To explore the core biological processes reflecting the pathophysiology of depression and to delineate homogeneous subgroups of depression in terms of treatment response and prognosis, objective measures of core biological process [biological markers] in depression have been studied using diverse approaches of altered blood levels for single molecules, genetic variants, epigenetic changes, as well as neuroimaging or electrophysiological findings. This chapter reviews the candidates of biological markers for MDD in general as well as more specifically per subtype, namely, melancholic and atypical.


Depression Subtyping Melancholic depression Atypical depression Trait marker Neuroimaging Electroencephalography Genetics 



This work was supported by a grant from the Korea Science and Engineering Foundation (KOSEF), funded by the Korean government (NRF-2015R1A2A2A01003564).


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Seoul National University HospitalSeoulSouth Korea
  2. 2.Yeongeon Student Support CenterSeoul National University College of MedicineSeoulSouth Korea
  3. 3.Clinical Emotion and Cognition Research LaboratoryInje UniversityGoyangSouth Korea
  4. 4.Department of PsychiatryIlsan Paik Hospital, Inje University College of MedicineGoyangKorea

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