Dual Depression: the challenge of the treatment. A traslational approach.

Dual depression, the co-occurrence of Major Depression and a Substance Use Disorder (SUD) , is a medical challenge because of the difficulties derived of a correct diagnosis and treatment. The present workshop will dissect the concept of dual diagnosis, and will explore its nature, the relationship with treatment-resistant depression, the clinical challenges, the preclinical models used for its analysis and the development of specific plasma biomarkers for the stratification of dual depression patients. As a short introduction, work moderator Dr. Marta Torrens will introduce the concept of Dual Depression. In the first talk, Dr. Francina Fonseca will describe the clinical portrait of dual depression patients, and the challenges faced by clinicians regarding its stratification, treatment options and consequences. The second talk, by Dr. Fernando Rodríguez de Fonseca will describe the relationship of Dual Depression with Treatment Resistant Depression, describing the neurobiological basis for the loss of efficacy of antidepressants in patients with SUD, and comparing with the current knowledge on treatment-resistant depression in patients without SUD. A special focus on microRNAs and microRNA-based novel therapies will be placed to highlight the new research lines aiming to improve the response to antidepressants. The third presentation will be given by Dr. Olga Valverde, and will offer a review of preclinical models of Dual Depression. The talk will address the presence of comorbidity between depression and cocaine-seeking behavior using animal models that allows researchers to reproduce the effects of childhood adversity, eventually leading to depression. This model permits the examination of the impact of early-life stress on cocaine use. These studies provide novel evidence regarding molecular mechanisms altered during comorbidity between cocaine seeking and depression, highlighting the involvement of motivation in this phenomenon and the evidence of a differential vulnerability related to sex. Finally, Dr. Antonia Serrano will describe the translational research performed to identify different sets of biomarkers of Dual Depression, including specific lipids (such as acylethanolamides or Lysophospatidic acid), cytokines, chemokines or specific metabolic products (i.e. aminoacids or tryptophan derivatives). These biomarkers will indeed help to better stratify dual depression patients, improving treatment outcomes. Finally, an overall open discussion with the attendants to the workshop will be established.