A. Agorastos, Greece

Aristotle University of Thessaloniki II. Dept. of Psychiatry
Dr. Agorastos is Assist. Professor of Psychiatry at the Aristotle University of Thessaloniki and International Partner of the VA Center of Excellence for Stress and Mental Health (CESAMH) at the University of California, San Diego (USCD), La Jolla, USA. He previously served as Assoc. Professor of Psychiatry and Psychotherapy at the University of Hamburg, Head of the Outpatient Psychiatric Services of the University Department of Psychiatry and Psychotherapy in Hamburg, and Team Leader of the Psychoneuroimmunology and Psychoneurophysiology Research Group of the Laboratory of Biological Psychiatry in the Hamburg University Medical Center. He received his MD at the Medical University of Vienna, completed his doctorate, clinical and psychotherapeutic training (Board Approval for CBT) and professorial thesis at the University of Hamburg, his MSc in Affective Neuroscience at the Universities of Maastricht and Florence and his Postdoc Fellowship at the Posttraumatic Stress Disorder (PTSD) research group of the CESAMH at USCD. Ηis current research focus centers in the neurobiology of stress and stress-related disorders with particular emphasis on psychoneuroendocrinology, -immunology and -physiology of stress, PTSD and depression and their neuropsychological correlates, as well as on the circadian system and chronodisruption

Presenter Of 4 Presentations

Symposium: The Collaborative Outcomes Study on Health and Functioning During Infection Times (COH-FIT): Results in Adults and Youth From Over 130 Countries (ID 283) No Topic Needed
e-Poster Presentations (ID 1106) AS09. Depressive disorders

EPP0507 - Inverse autonomic stress reactivity in depressed patients with and without prior history of depression

Session Name
e-Poster Presentations (ID 1106)
Date
Sun, 11.04.2021
Session Time
07:30 - 23:59
Room
e-Poster Gallery
Lecture Time
07:30 - 07:30

ABSTRACT

Introduction

There is a considerable association between major depressive disorder (MDD) and cardiovascular disease, most possibly relying on abnormalities in the autonomic nervous system (ANS)-related cardiac reactivity, although the exact underlying pathophysiological pathway is unclear.

Objectives

This study tends to shed some additional light on this background by investigating ANS reactivity in MDD with respect to previous depression history through an objective stress challenge paradigm.

Methods

The study assessed the effects of an overnight hypothalamus-pituitary-adrenal (HPA) axis stimulation with metyrapone (MET) on baseline ANS activity through linear and non-linear heart rate variability (HRV) measures in the morning of two continuous days in a group of 14 physically healthy, antidepressant-free patients with clinical, non-psychotic MDD, to investigate differences in autonomic reactivity with respect to prior MDD history.

Results

The main findings of this study include statistically significant time x group interactions with respect to several HRV measures, suggesting substantial differences on autonomic reactivity between patients with and without depression history. Hereby, recurrent-episode MDD patients showed lower vagal activity, while first-episode MDD patients increased PNS activity after HPA axis stimulation.

Conclusions

These findings indicate that HPA axis stimulation in MDD patients leads to inverse vagal response according to MDD history. We suggest that chronic stress system overactivation, as found in MDD, might lead to a progressive inversion of the original stress response through HPA axis and ANS divergence over the course of a recurrent illness. HRV could, thus, represent a significant biomarker in MDD with temporal sensitivity.

Hide
e-Poster Presentations (ID 1106) AS31. Precision Psychiatry

EPP0955 - Vasopressin Surrogate Marker Copeptin as a Potential Novel Endocrine Biomarker for Antidepressant Treatment Response in Major Depression: A Pilot Study

Session Name
e-Poster Presentations (ID 1106)
Date
Sun, 11.04.2021
Session Time
07:30 - 23:59
Room
e-Poster Gallery
Lecture Time
07:30 - 07:30

ABSTRACT

Introduction

Major depressive disorder (MDD) constitutes the leading cause of disability worldwide. Although efficacious antidepressant pharmacotherapies exist for MDD, only about 40-60% of the patients respond to initial treatment. However, there is still a lack of robustly established and applicable biomarkers for antidepressant response in everyday clinical practice.

Objectives

This study targets the assessment of the vasopressin (AVP) surrogate marker Copeptin (CoP), as a potential peripheral hypothalamic-level biomarker of antidepressant treatment response in MDD.

Methods

We measured baseline and dynamic levels of plasma CoP along with plasma ACTH and cortisol (CORT) in drug-naive outpatients with MDD before and after overnight manipulation of the hypothalamic-pituitary-adrenal (HPA) axis [i.e., stimulation (metyrapone) and suppression (dexamethasone)] on three consecutive days and their association with treatment response to 4 weeks of escitalopram treatment.

Results

Our findings suggest significantly higher baseline and post-metyrapone plasma CoP levels in future non-responders, a statistically significant invert association between baseline CoP levels and probability of treatment response and a potential baseline plasma CoP cut-off level of above 2.9 pmol/L for future non-response screening. Baseline and dynamic plasma ACTH and CORT levels showed no association with treatment response.

Conclusions

This pilot study provide first evidence in humans that CoP may represent a novel, clinically easily applicable, endocrine biomarker of antidepressant response, based on a single-measurement, cut-off level. These findings, underline the role of the vasopressinergic system in the pathophysiology of MDD and may represent a significant new tool in the clinical and biological phenotyping of MDD enhancing individual-tailored therapies.

Hide
Symposium: The Collaborative Outcomes Study on Health and Functioning During Infection Times (COH-FIT): Results in Adults and Youth From Over 130 Countries (ID 283) No Topic Needed

S0114 - Main Global COH-FIT Results in Adults

Session Icon
Pre-Recorded with Live Q&A
Date
Mon, 12.04.2021
Session Time
17:30 - 19:00
Room
Channel 4
Lecture Time
17:47 - 18:04