The Exposome of Major Depressive Disorder in an Egyptian Sample: A Pilot Study

Abstract

<title>Abstract</title> Background Major depressive disorder (MDD) has been recognized as a global public health concern affecting the lives of 264 million people with increasing prevalence worldwide. Inspired by the exposomic research, this study aims to investigate the dynamic and complex interplay between different demographic, lifestyle, environmental factors and bimolecular factors that are potentially involved in the pathogenesis of MDD in a sample of Egyptian adults living in Cairo. Methods The sample included 107 adults from both genders between the ages of 18 and 50. Convenience sampling was used to recruit participants from different social and community platforms. Participants were excluded on the basis of having comorbid psychotic or neurodegenerative disorders, terminal conditions and cognitive disabilities that might interfere with their clinical presentation. A comprehensive questionnaire was developed and then refined to collect demographic, psychosocial, lifestyle and environmental data in addition to a mini mental state examination (MMSE). Additionally, the Arabic version of the Beck Depression Inventory-II (BDI-II) was used to assess the severity of depressive symptoms and to generate a symptoms profile. The Arabic Mini International Neuropsychiatric Interview (MINI 7.0.2) was used to diagnostically differentiate between participants with MDD and healthy controls in addition to identifying cases of past episodes and recurrent episodes of MDD. Participants were also required to give blood samples for the examination of a wide range of biomarkers including EGF, FGF-2, FGF-9, FGF-21, FGF-22, IFN-γ, IGF-1, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, TNF-α, VEGFC, and VEGFD in addition to complete blood parameters. Results Results show several significant correlations between different inflammatory and neurotrophic biomarkers. Significant correlations were also established between different lifestyle factors and biomarkers, and MDD outcomes. Conclusion Despite its limitations, this study offers valuable insights about the complexity of MDD in an Egyptian sample combining psychosocial, environmental and biomolecular data. Such findings highlight the pressing need for a more personalized approach in the study of MDD. It shows real potential of investing in precision mental health research for the development and enhancement of personalized intervention and prevention strategies.