{
  "abstract": "Background: Elevated inflammatory biomarkers have been consistently associated with a subset of depressive symptoms, particularly atypical and energy-related features, as well as antidepressant treatment resistance. This evidence has supported the definition of an inflammatory subtype of major depressive disorder (ISMDD), characterized by immune-inflammatory dysregulation and reduced response to first- and second-line antidepressants. However, a lack of consensus on its definition and assessment tools limits research and treatment development. Methods: Using a Delphi approach, international experts from the ASPIRE consortium (Advanced Stratification of People with Depression based on Inflammation, n = 25) identified ISMDD symptom domains, which were then evaluated by the European College of Neuropsychopharmacology Immuno-Neuropsychiatry Network (INPN-ECNP, n = 12). Using the same consensus structure, the coverage of these domains by depression rating scales was then assessed. People with lived experience (PWLE, n = 11) provided perspectives on the clinical relevance and impact of the emerged symptoms. Results: ASPIRE consensus identified ten ISMDD symptom domains: fatigue/low energy, hypersomnia, increased weight/appetite, cognitive difficulties, lack of motivation, anhedonia, diminished interest, leaden paralysis, psychomotor retardation, and insomnia, with the first five of being also confirmed by INPN-ECNP consensus. Except for increased weight/appetite, PWLE identified these domains as negatively affecting quality of life; most of them also reported as not sufficiently assessed in clinical care. Among rating scales, the Inventory of Depressive Symptomatology Self-Rated was the only instrument covering all ISMDD domains, whereas the Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale covered only four and six domains, respectively. Conclusion: These findings support a framework for ISMDD and highlight the importance of symptom assessment to improve clinical evaluation, research, and personalized immunopsychiatric treatment.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 41,
  "authors": [
    {
      "name": "Benedetta Vai"
    },
    {
      "name": "Tommaso Cazzella"
    },
    {
      "name": "Camilla Monopoli"
    },
    {
      "name": "Beatrice Bravi"
    },
    {
      "name": "Anastasia Kontogianni"
    },
    {
      "name": "Celine Wessa"
    },
    {
      "name": "Courtney Worrell"
    },
    {
      "name": "Maria Simon"
    },
    {
      "name": "Bernhard Baune"
    },
    {
      "name": "Francesco Benedetti"
    },
    {
      "name": "Annamaria Cattaneo"
    },
    {
      "name": "Erik Van Der Eycken"
    },
    {
      "name": "Jennifer Felger"
    },
    {
      "name": "Stefan Gold"
    },
    {
      "name": "Neil Harrison"
    },
    {
      "name": "Nadia Hoffman"
    },
    {
      "name": "Femke Lamers"
    },
    {
      "name": "Marion Leboyer"
    },
    {
      "name": "Giulia Lombardo"
    },
    {
      "name": "Fanni-Laura Mäntylä"
    },
    {
      "name": "Andrew Miller"
    },
    {
      "name": "Valeria Mondelli"
    },
    {
      "name": "Brenda W.J.H. Penninx"
    },
    {
      "name": "Dan Stein"
    },
    {
      "name": "Luca Sforzini"
    },
    {
      "name": "Francesco Bavato"
    },
    {
      "name": "Michael Berk"
    },
    {
      "name": "Alessandra Borsini"
    },
    {
      "name": "Igor Branchi"
    },
    {
      "name": "Lucile Capuron"
    },
    {
      "name": "Javier Caso"
    },
    {
      "name": "Janet Cunningham"
    },
    {
      "name": "Paolo Fusar-Poli"
    },
    {
      "name": "Bartholomeus C.M. Haarman"
    },
    {
      "name": "Aiste Lengvenyte"
    },
    {
      "name": "Emanuele Osimo"
    },
    {
      "name": "Christian Otte"
    },
    {
      "name": "Thomas Pollak"
    },
    {
      "name": "Nils Eiel Steen"
    },
    {
      "name": "Carmine Pariante"
    },
    {
      "name": "Livia De Picker"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6q3m4k969a62w.bib",
  "cited_by": 2,
  "doi": "10.1016/j.bbi.2026.106957",
  "fulltext_url": null,
  "id": "6q3m4k969a62w",
  "issns": [
    "0889-1591",
    "1090-2139"
  ],
  "landing_url": "https://hal.science/hal-05723195v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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  "pdf_url": "https://hal.science/hal-05723195/document",
  "pmcid": null,
  "pmid": "42604707",
  "published": "2026-08-16",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6q3m4k969a62w.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:58Z",
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  "subjects": [
    {
      "field": "biology",
      "origin": "hal:1.scco.neur",
      "subfield": "neuroscience"
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    {
      "field": "medicine",
      "origin": "hal:2.sdv.mhep.psm",
      "subfield": "psychiatry"
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  "title": "A Delphi-method-based consensus for clinical domains and assessment of the inflammatory subtype of major depressive disorder from the ASPIRE study",
  "title_text": "A Delphi-method-based consensus for clinical domains and assessment of the inflammatory subtype of major depressive disorder from the ASPIRE study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:58Z",
  "url": "https://research.draconitic.com/paper/6q3m4k969a62w",
  "venue": "Brain, Behavior, and Immunity",
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}