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Trombello JM, Cooper CM, Fatt CC, Grannemann BD, Carmody TJ, Jha MK, Mayes TL, Greer TL, Yezhuvath U, Aslan S, Pizzagalli DA, Weissman MM, Webb CA, Dillon DG, McGrath PJ, Fava M, Parsey RV, McInnis MG, Etkin A, Trivedi MH. Neural substrates of emotional conflict with anxiety in major depressive disorder: Findings from the Establishing Moderators and biosignatures of Antidepressant Response in Clinical Care ( EMBARC) randomized controlled trial. J Psychiatr Res 2022; 149:243-251. [PMID: 35290819 PMCID: PMC9746288 DOI: 10.1016/j.jpsychires.2022.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/16/2022] [Accepted: 03/07/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND The brain circuitry of depression and anxiety/fear is well-established, involving regions such as the limbic system and prefrontal cortex. We expand prior literature by examining the extent to which four discrete factors of anxiety (immediate state anxiety, physiological/panic, neuroticism/worry, and agitation/restlessness) among depressed outpatients are associated with differential responses during reactivity to and regulation of emotional conflict. METHODS A total of 172 subjects diagnosed with major depressive disorder underwent functional magnetic resonance imaging while performing an Emotional Stroop Task. Two main contrasts were examined using whole brain voxel wise analyses: emotional reactivity and emotion regulation. We also evaluated the association of these contrasts with the four aforementioned anxiety factors. RESULTS During emotional reactivity, participants with higher immediate state anxiety showed potentiated activation in the rolandic operculum and insula, while individuals with higher levels of physiological/panic demonstrated decreased activation in the posterior cingulate. No significant results emerged for any of the four factors on emotion regulation. When re-analyzing these statistically-significant brain regions through analyses of a subsample with (n = 92) and without (n = 80) a current anxiety disorder, no significant associations occurred among those without an anxiety disorder. Among those with an anxiety disorder, results were similar to the full sample, except the posterior cingulate was associated with the neuroticism/worry factor. CONCLUSIONS Divergent patterns of task-related brain activation across four discrete anxiety factors could be used to inform treatment decisions and target specific aspects of anxiety that involve intrinsic processing to attenuate overactive responses to emotional stimuli.
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Affiliation(s)
- Joseph M. Trombello
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Crystal M. Cooper
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Neuroscience Research, Cook Children’s Medical Center, Fort Worth, TX, USA
| | - Cherise Chin Fatt
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Bruce D. Grannemann
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas J. Carmody
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Manish K. Jha
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L. Mayes
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tracy L. Greer
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Department of Psychology, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Sina Aslan
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Advance MRI LLC, Frisco, TX, USA
| | - Diego A. Pizzagalli
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Myrna M. Weissman
- Columbia University, Department of Psychiatry, New York, NY, USA,New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Christian A. Webb
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Daniel G. Dillon
- Harvard Medical School, McLean Hospital, Department of Psychiatry, Boston, MA, USA
| | - Patrick J. McGrath
- Columbia University, Department of Psychiatry, New York, NY, USA,New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA
| | - Maurizio Fava
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, USA
| | - Ramin V. Parsey
- Stony Brook University, Department of Psychiatry, Stony Brook, NY, USA
| | - Melvin G. McInnis
- University of Michigan, Department of Psychiatry, Ann Arbor, MI, USA
| | - Amit Etkin
- Stanford University School of Medicine, Department of Psychiatry, Palo Alto, CA, USA
| | - Madhukar H. Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA,Corresponding author. Center for Depression Research and Clinical Care, Peter O’Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, USA. (M.H. Trivedi)
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Chin Fatt CR, Jha MK, Cooper CM, Fonzo G, South C, Grannemann B, Carmody T, Greer TL, Kurian B, Fava M, McGrath PJ, Adams P, McInnis M, Parsey RV, Weissman M, Phillips ML, Etkin A, Trivedi MH. Effect of Intrinsic Patterns of Functional Brain Connectivity in Moderating Antidepressant Treatment Response in Major Depression. Am J Psychiatry 2020; 177:143-154. [PMID: 31537090 DOI: 10.1176/appi.ajp.2019.18070870] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Major depressive disorder is associated with aberrant resting-state functional connectivity across multiple brain networks supporting emotion processing, executive function, and reward processing. The purpose of this study was to determine whether patterns of resting-state connectivity between brain regions predict differential outcome to antidepressant medication (sertraline) compared with placebo. METHODS Participants in the Establishing Moderators and Biosignatures of Antidepressant Response in Clinical Care (EMBARC) study underwent structural and resting-state functional MRI at baseline. Participants were then randomly assigned to receive either sertraline or placebo treatment for 8 weeks (N=279). A region of interest-based approach was utilized to compute functional connectivity between brain regions. Linear mixed-model intent-to-treat analyses were used to identify brain regions that moderated (i.e., differentially predicted) outcomes between the sertraline and placebo arms. RESULTS Prediction of response to sertraline involved several within- and between-network connectivity patterns. In general, higher connectivity within the default mode network predicted better outcomes specifically for sertraline, as did greater between-network connectivity of the default mode and executive control networks. In contrast, both placebo and sertraline outcomes were predicted (in opposite directions) by between-network hippocampal connectivity. CONCLUSIONS This study identified specific functional network-based moderators of treatment outcome involving brain networks known to be affected by major depression. Specifically, functional connectivity patterns of brain regions between and within networks appear to play an important role in identifying a favorable response for a drug treatment for major depressive disorder.
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Affiliation(s)
- Cherise R Chin Fatt
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Manish K Jha
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Crystal M Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Gregory Fonzo
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Charles South
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Bruce Grannemann
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Thomas Carmody
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Tracy L Greer
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Benji Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Maurizio Fava
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Patrick J McGrath
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Phillip Adams
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Melvin McInnis
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Ramin V Parsey
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Myrna Weissman
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Mary L Phillips
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Amit Etkin
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Chin Fatt, Jha, Cooper, South, Grannemann, Carmody, Greer, Kurian, Trivedi); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Jha); Department of Psychiatry and Behavioral Sciences and Stanford Neurosciences Institute, Stanford University, Stanford, Calif. (Fonzo, Etkin); Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. (Fonzo, Etkin); Department of Psychiatry, Massachusetts General Hospital, Boston (Fava); New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York (McGrath, Adams, Weissman); Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor (McInnis); Department of Psychiatry and Behavioral Science and Department of Radiology, Stony Brook University, Stony Brook, N.Y. (Parsey); and Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (Phillips)
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