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Identifying Physiological and Cognitive Indicators of Subthreshold Depression and Major Depressive Disorder

Ayaka Shimizu1, Satoshi Yokoyama2, Alan S R Fermin1

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Summary

Subthreshold depression (StD) is linked to physiological and cognitive changes similar to major depressive disorder (MDD). Persistent StD symptoms may predict MDD onset, highlighting potential early detection markers.

Keywords:
cognitive functionemotion recognitionheart rate variabilitymajor depressive disordersubthreshold depressionvoice analysis

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Psychology

Background:

  • Subthreshold depression (StD) presents symptoms below the major depressive disorder (MDD) diagnostic threshold.
  • StD is associated with functional impairment and an elevated risk of developing MDD.
  • Objective physiological and cognitive markers for StD remain largely uncharacterized.

Purpose of the Study:

  • To identify objective physiological and cognitive markers associated with Subthreshold Depression (StD).
  • To validate predictive factors for the onset of Major Depressive Disorder (MDD) in individuals with StD.

Main Methods:

  • 168 university students were assessed, classified into StD (n=87) or control (n=81) groups using the Beck Depression Inventory-II (BDI-II).
  • The StD group was further divided into low (BDI-II < 10) and maintained (BDI-II ≥ 10) subgroups.
  • Assessments included voice analysis, heart rate variability (HRV), body temperature, emotion recognition, and neurocognitive tasks, with follow-up for MDD onset.

Main Results:

  • The StD group exhibited increased vocal arousal, higher peripheral body temperature, and reduced low-frequency HRV compared to controls.
  • Impairments were observed in sustained attention, executive function, and emotion recognition (happy, surprised expressions) in the StD group.
  • The maintained depression subgroup showed more severe impairments and a higher incidence of MDD onset (7 cases), while the low depression group had selective deficits without MDD onset.

Conclusions:

  • StD is associated with physiological and cognitive abnormalities mirroring those in MDD.
  • Persistent symptoms in StD indicate a higher risk for progression to MDD.
  • Voice arousal, HRV, body temperature, and emotion recognition serve as potential markers for early StD identification and risk stratification.