MedicalResearch.com Interview with:
Dr. Markus Rütgen PhD
Social, Cognitive and Affective Neuroscience Unit
Faculty of Psychology
University of Vienna
MedicalResearch.com: What is the background for this study?
Response: Previous research has reported empathy deficits in patients with major depressive disorder. However, a high percentage of patients taking part in these studies were taking antidepressants, which are known to influence emotion processing. In our study, we wanted to overcome this important limitation. We were interested in whether the previously reported empathic deficits were attributable to the acute state of depression, or to the antidepressant treatment.
To this end, we performed a longitudinal neuroimaging study, in which we measured brain activity and self-reported empathy in response to short video clips showing people in pain. We measured acutely depressed patients twice. First, before they started their treatment, second, after three months of treatment with a state-of-the-art antidepressant (selective serotonin reuptake inhibitors).
MedicalResearch.com: What are the main findings?
Response: Before treatment, neither self-reported empathy nor neural activity in brain regions associated with empathy differed between depressed patients and healthy controls. After treatment, patients reported lower empathy and showed reduced activity in the neural empathy network. These reductions of empathy were associated with symptom improvement across time. In contrast, neural responses to electrical pain were unchanged by treatment, which speaks for a specific effect for the perception of negative emotions in a social context. This contradicts previous reports of deficits in empathic responding in depressed patients and suggests that antidepressants lead to reduced empathy.
MedicalResearch.com: What should readers take away from your report?
Response: Our findings shed a different light on depression-related changes in empathy. Lowering the affective impact of negative emotions might help patients to recover more easily. On the other hand, the observed reductions may also impair the quality of their social relationships.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Whether the observed changes in empathic responding lead to direct consequences in real-life social interactions remains an open question for future research. I would like to emphasize that future research should carefully control for medication status before assigning specific deficits to groups of patients suffering from clinical conditions in general. Thereby, we can avoid stigmatization of people who are already having hard times in their lives.
RL received travel grants and/or conference speaker honoraria from AstraZeneca, Lundbeck A/S, Dr. Willmar Schwabe GmbH, Orphan Pharmaceuticals AG, Janssen-Cilag Pharma GmbH, and Roche Austria GmbH. TV received travel grants and compensation for workshop participation from Pfizer and Eli Lilly and speaker honorary from Shire. CK received travel grants from Roche Austria GmbH and AOP Orphan.
Markus Rütgen, Carolina Pletti, Martin Tik, Christoph Kraus, Daniela Melitta Pfabigan, Ronald Sladky, Manfred Klöbl, Michael Woletz, Thomas Vanicek, Christian Windischberger, Rupert Lanzenberger, Claus Lamm. Antidepressant treatment, not depression, leads to reductions in behavioral and neural responses to pain empathy. Translational Psychiatry, 2019; 9 (1) DOI: 10.1038/s41398-019-0496-4
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