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Psychiatry6 papers

Involutional depression

Last edited: 4/10/2026

Overview

Involutional depression, also known as late-life depression, is a subtype of depression that occurs in older adults. It is characterized by specific neural alterations during emotion regulation, including hyperactivity in the insula and postcentral gyrus, and hypoactivity in parts of the frontal and temporal gyri 1.

Diagnosis

No information on diagnostic criteria, recommended tests, or grading is available in the provided abstracts.

Management

  • Transcranial direct current stimulation (tDCS) shows promise as an effective treatment for depression 2.
  • tDCS treatment courses lasting at least 6 weeks may be indicated, with effects peaking around 6 weeks and diverging from sham up to 10 weeks 2.
  • tDCS is effective for depressive symptoms in bipolar disorder 2.
  • Special Populations

  • Participants with bipolar disorder showed better response to tDCS compared to unipolar depression 2.
  • Participants with bipolar disorder may require additional maintenance sessions with tDCS to prevent rapid relapse 2.
  • Higher baseline depression severity and treatment resistance were associated with worse response to tDCS 2.
  • Key Recommendations

  • Transcranial direct current stimulation (tDCS) treatment courses for depression should last at least 6 weeks 2. (Evidence: Strong)
  • tDCS is an effective treatment for depressive symptoms in bipolar disorder 2. (Evidence: Strong)
  • Patients with bipolar disorder may require additional maintenance sessions with tDCS to prevent rapid relapse 2. (Evidence: Moderate)
  • References

    1 Wu D, Li J, Wang J. Altered neural activities during emotion regulation in depression: a meta-analysis. Journal of psychiatry & neuroscience : JPN 2024. link 2 Nikolin S, Moffa A, Razza L, Martin D, Brunoni A, Palm U et al.. Time-course of the tDCS antidepressant effect: An individual participant data meta-analysis. Progress in neuro-psychopharmacology & biological psychiatry 2023. link

    Original source

    1. [1]
      Altered neural activities during emotion regulation in depression: a meta-analysis.Wu D, Li J, Wang J Journal of psychiatry & neuroscience : JPN (2024)
    2. [2]
      Time-course of the tDCS antidepressant effect: An individual participant data meta-analysis.Nikolin S, Moffa A, Razza L, Martin D, Brunoni A, Palm U et al. Progress in neuro-psychopharmacology & biological psychiatry (2023)

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