June 27, 2019
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Antidepressants, not depression, reduce behavioral responses to empathy

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Contrary to prior cross-sectional reports of empathy deficits in major depression, study findings published in Translational Psychiatry indicated that antidepressant treatment decreased aversive responses triggered by exposure to the suffering of others.

“[Although] the impact of major depressive disorder on mood and basic emotional processing has been investigated intensely, few attempts have been made to explore its influence on empathy, which is a crucial skill for everyday social interactions,” Markus Rütgen, PhD, postdoctoral researcher in the social, cognitive and affective neuroscience unit at University of Vienna in Austria, and colleagues wrote.

To separate the effects of MDD and antidepressant treatment, the researchers conducted a longitudinal neuroimaging study on empathy among 29 patients (median age, 29.6 years; women, n = 21) with depression.

Participants who underwent two functional MRI sessions before and after 3 months of antidepressant therapy completed an empathy-for-pain task, in which they watched videos of people undergoing painful medical procedures, as well as an additional electrical pain task to control for general effects on processing of negative affective states. The investigators compared their responses to those of 35 healthy controls (median age, 27.4 years; women, n = 23). Participants also gave self-report ratings targeting cognitive (perspective taking) and affective (unpleasant affect) aspects of empathy.

Rütgen and colleagues found no behavioral or neural differences between patients with depression and controls before antidepressant treatment. After 3 months of treatment, patients with MDD exhibited reduced neural responses in a priori brain areas specifically associated with empathy for pain (bilateral anterior insular and anterior midcingulate cortex) as well as reduced self-experienced unpleasant affect in response to others’ pain.

In addition, the results showed that reductions in affective empathy were linked to symptom improvement, and functional connectivity during the empathy task between brain regions tied to affective (anterior insula) and cognitive (precuneus) empathy dropped between sessions among those with MDD.

"The lowered emotional impact of negative events in a social context possibly allows patients to recover more easily,” Rütgen said in a press release. “Nevertheless, the actual impact of reduced empathy on patients' social behavior remains to be explored." – by Savannah Demko

Disclosure: Rütgen reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.