Author(s):
Harini. M.B, Pinki Verma
Email(s):
vermapinki05@gmail.com
DOI:
10.52711/2231-5659.2026.00063 
Address:
Harini. M.B1, Pinki Verma2*
1Research Scholar, Department of Pharmacology, Aditya Bangalore Institute of Pharmacy Education & Research, Yelahanka, Bengaluru - 560064, Karnataka, India.
2Associate Professor, Department of Pharmacology, Aditya Bangalore Institute of Pharmacy Education & Research, Yelahanka, Bengaluru - 560064, Karnataka, India.
*Corresponding Author
Published In:
Volume - 16,
Issue - 4,
Year - 2026
ABSTRACT:
Background: Stress, anxiety, and depression are closely intertwined, with chronic stress often triggering comorbid anxiety and depressive disorders. The overlap of these conditions complicates treatment, emphasizing the necessity for integrated models that target both anxiolytic and antidepressive mechanisms concurrently. Such models could provide more effective, personalized strategies for managing these complex conditions.
Main Body: This review examines the neurobiological foundations of stress, anxiety, and depression, highlighting the dysregulation of the HPA axis, along with the roles of monoaminergic systems (serotonin, norepinephrine, dopamine) and GABAergic and glutamatergic pathways in the regulation of mood and anxiety. Dysfunctions in these systems, such as altered cortisol and CRH dynamics in the HPA axis, contribute to the pathophysiology of stress-related disorders. Moreover, neuroplasticity, particularly BDNF-mediated neurogenesis, plays a key role in the therapeutic effects of antidepressant treatments. Pharmacological interventions, including SSRIs, SNRIs, and atypical antidepressants, are discussed for their ability to alleviate both anxiety and depression symptoms. The review also addresses the complexities of polypharmacy and the potential benefits and risks of combination therapies. In addition to pharmacological approaches, non-pharmacological treatments such as cognitive-behavioural therapy (CBT), mindfulness techniques, and nutraceuticals (e.g., adaptogens, omega-3s) are emphasized as essential elements of an integrative care model. Furthermore, emerging therapies like psychedelics and neurostimulation show promise in managing treatment-resistant conditions. The review introduces the Serenity Spectrum Model, an integrative framework combining pharmacological, psychological, and lifestyle interventions. This model underscores the importance of tailoring treatments to individual needs and fostering a biopsychosocial approach to mental health. Conclusion: The most effective approach to stress relief involves targeting both anxiolytic and antidepressive pathways in a multimodal and personalized manner. The Serenity Spectrum Model offers a foundation for integrating diverse therapeutic approaches to improve mental well-being. Despite ongoing challenges, such as the need for biomarkers and addressing polypharmacy risks, the model sets the stage for more comprehensive and sustainable mental health care strategies.
Cite this article:
Harini. M.B, Pinki Verma. The Serenity Spectrum: Integrating Anxiolytic and Antidepressant Mechanisms for Stress relief. Asian Journal of Research in Pharmaceutical Sciences. 2026; 16(4):444-4. doi: 10.52711/2231-5659.2026.00063
Cite(Electronic):
Harini. M.B, Pinki Verma. The Serenity Spectrum: Integrating Anxiolytic and Antidepressant Mechanisms for Stress relief. Asian Journal of Research in Pharmaceutical Sciences. 2026; 16(4):444-4. doi: 10.52711/2231-5659.2026.00063 Available on: https://www.ajpsonline.com/AbstractView.aspx?PID=2026-16-4-16
REFERENCES:
1. World Health Organization. Depression and other common mental disorders: global health estimates. Geneva: World Health Organization; 2021.
2. Anshika Garg. Nature’s Mental Health Toolkit: Herbal Remedies for Anxiety and Depression. Research Journal of Pharmacognosy and Phytochemistry. 2025; 17(1): 45-8. doi: 10.52711/0975-4385.2025.00008
3. Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E. Cost of disorders of the brain in Europe. Eur Neuropsychopharmacology 2011; 21(10): 718–79. doi:10.1016/j.euroneuro.2011.08.008.
4. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005; 62(6): 617–27. doi:10.1001/archpsyc.62.6.617.
5. Duman RS, Aghajanian GK, Sanacora G, Krystal JH. Synaptic plasticity and depression: new insights from stress and rapid-acting antidepressants. Nat Med. 2016; 22(3): 238–47. doi:10.1038/nm.4050.
6. McEwen BS, Bowles NP, Gray JD, Hill MN, Hunter RG, Karatsoreos IN. Mechanisms of stress in the brain. Nat Neurosis. 2015; 18(10):1353–63. doi:10.1038/nn.4086.
7. Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Int J Neuropsychopharmacol. 2017; 20(2): 101–9. doi:10.1093/ijnp/pyw076.
8. Pittenger C, Duman RS. Stress, depression, and neuroplasticity: a convergence of mechanisms. Neuropsychopharmacology. 2008; 33(1): 88–109. doi:10.1038/sj.npp.1301574.
9. Zorn JV, Schür RR, Boks MP, Kahn RS, Joëls M, Vinkers CH. Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017; 77: 25–36. https://doi.org/10.1016/j.psyneuen.2016.11.036
10. Herman JP, McKlveen JM, Solomon MB, Carvalho-Netto E, Myers B. Neural regulation of the stress response: glucocorticoid feedback mechanisms. Brazilian J Med Biol Res. 2012; 45(4): 292–8. https://doi.org/10.1590/S0100-879X2012007500041
11. Pariante CM, Lightman SL. The HPA axis in major depression: classical theories and new developments. Trends Neuroscience. 2008; 31(9): 464–8. https://doi.org/10.1016/j.tins.2008.06.006
12. Dedovic K, Duchesne A, Andrews J, Engert V, Pruessner JC. The brain and the stress axis: The neural correlates of cortisol regulation in response to stress. Neuroimage. 2009; 47(3): 864–71. https://doi.org/10.1016/j.neuroimage.2009.05.074
13. Dunlop BW, Nemeroff CB. The role of dopamine in the pathophysiology of depression. Arch Gen Psychiatry. 2007; 64(3): 327–37. https://doi.org/10.1001/archpsyc.64.3.327
14. Ressler KJ, Nemeroff CB. Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders. Depress Anxiety 2000; 12(Suppl 1): 2–19. https://doi.org/10.1002/1520-6394(2000)12:1+<2::AID-DA2>3.0.CO;2-4
15. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JPT, Churchill R. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009; 373(9665): 746–58. https://doi.org/10.1016/S0140-6736(09)60046-5
16. Blier P. Neurobiology of depression and mechanism of action of depression treatments. J Clin Psychiatry. 2001; 62(Suppl15): 7–12. https://pubmed.ncbi.nlm.nih.gov/11434499/
17. Möhler H. The GABA system in anxiety and depression and its therapeutic potential. Neuropharmacology. 2012; 62(1): 42–53. https://doi.org/10.1016/j.neuropharm.2011.08.040
18. Rudolph U, Knoflach F. Beyond classical benzodiazepines: novel therapeutic potential of GABAA_AA receptor subtypes. Nat Rev Drug Discovery. 2011; 10(9): 685–97. https://doi.org/10.1038/nrd3502
19. Duman RS, Aghajanian GK. Synaptic dysfunction in depression: potential therapeutic targets. Science. 2012; 338(6103): 68–72. https://doi.org/10.1126/science.1222939
20. Zarate CA Jr, Singh JB, Carlson PJ, Brutsche NE, Ameli R, Luckenbaugh DA. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006; 63(8): 856–64. https://doi.org/10.1001/archpsyc.63.8.856
21. Duman RS, Monteggia LM. A neurotrophic model for stress-related mood disorders. Biol Psychiatry. 2006; 59(12): 1116–27. https://doi.org/10.1016/j.biopsych.2006.02.013
22. Castrén E, Rantamäki T. The role of BDNF and its receptors in depression and antidepressant drug action: Reactivation of developmental plasticity. Dev Neurobiology. 2010; 70(5): 289–97. https://doi.org/10.1002/dneu.20758
23. Martinowich K, Lu B. Interaction between BDNF and serotonin: Role in mood disorders. Neuropsychopharmacology. 2008; 33(1): 73–83. https://doi.org/10.1038/sj.npp.1301571
24. Schmidt HD, Duman RS. Peripheral BDNF produces antidepressant-like effects in cellular and behavioral models. Neuropsychopharmacology. 2010; 35(12): 2378–91. https://doi.org/10.1038/npp.2010.114
25. Vyas Amee S, Digvijaysinh G. Rana. Hyponatremia in Depression: A Review. Asian Journal of Pharmaceutical Research. 2025; 15(1): 43-0. doi: 10.52711/2231-5691.2025.00008
26. Baldwin DS, Anderson IM, Nutt DJ, Bandelow B, Bond A, Davidson JR, Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: 2014
27. Cipriani A, Furukawa TA, Salanti G, Geddes JR, Higgins JP, Churchill R. Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis. Lancet. 2009; 373(9665): 746–58. https://doi.org/10.1016/S0140-6736(09)60046-5
28. Davidson JR. Pharmacotherapy of generalized anxiety disorder. J Clin Psychiatry. 2001; 62 Suppl 11: 46–50. https://pubmed.ncbi.nlm.nih.gov/11434456/
29. Watanabe N, Omori IM, Nakagawa A, Cipriani A, Barbui C, Churchill R. Mirtazapine versus other antidepressive agents for depression. Cochrane Database Syst Rev. 2011; 12: CD006528. https://doi.org/10.1002/14651858.CD006528.pub2
30. Papakostas GI. Tolerability of modern antidepressants. J Clin Psychiatry. 2008; 69 Suppl E1: 8–13. https://pubmed.ncbi.nlm.nih.gov/19121285/
31. Rickels K, Garcia-Espana F, Mandos LA, Case WG, Weise CM. Buspirone augmentation of selective serotonin reuptake inhibitors for anxiety disorders. J Clin Psychiatry. 2000; 61(9): 640–5. https://doi.org/10.4088/JCP.v61n0904
32. Blier P, Ward HE, Tremblay P, Laberge L, Hebert C, Bergeron R. Combination of antidepressant medications from treatment initiation for major depressive disorder: a double-blind randomized study. Am J Psychiatry. 2010; 167(3): 281–8. https://doi.org/10.1176/appi.ajp.2009.09020186
33. Pande AC. Crockatt JG, Feltner DE, Janney CA, Smith WT, Weisler RH. Pregabalin in generalized anxiety disorder: a placebo-controlled trial. Am J Psychiatry. 2003; 160(3): 533–40. https://doi.org/10.1176/appi.ajp.160.3.533
34. Frampton JE. Pregabalin: A review of its use in adults with generalized anxiety disorder. CNS Drugs. 2014; 28(9): 835–54. https://doi.org/10.1007/s40263-014-0185-0
35. Steenen SA, van Wijk AJ, van der Heijden GJ, van Westrhenen R, de Lange J, de Jongh A. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis. J Psychopharmacol. 2016; 30(2): 128–39. https://doi.org/10.1177/0269881115622244
36. Tyrer P. Anxiolytics in the 21st century: A review of recent studies and future directions. World Psychiatry. 2010; 9(3): 123–4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948747/
37. Avinash B. Thalkari, Pawan N. Karwa, Chandrakant S. Gawli. A Review on Online Pharmacy: Views and Counterviews. Asian J. Pharm. Tech. 2018; 8(2): 108-111. doi: 10.5958/2231-5713.2018.00017.X
38. Fava M, Rush AJ, Thase ME. 16- and 24-week outcomes of combination treatment for major depressive disorder: A randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2008; 69(11): 1773–9. https://doi.org/10.4088/JCP.v69n1104
39. Papakostas GI, Shelton RC, Zisook S, A double-blind, randomized trial of buspirone and sertraline in patients with comorbid depression and anxiety. Am J Psychiatry. 2006; 163(5): 960–8. https://doi.org/10.1176/appi.ajp.163.5.960
40. Gillman PK. Monoamine oxidase inhibitors: A review of the pharmacology and clinical applications. J Clin Psychopharmacol. 2007; 27(5): 473–82. https://doi.org/10.1097/01.jcp.0000272547.92299.2e
41. Gelenberg AJ, Freeman MP, Markowitz JC. A review of the pharmacologic treatment of major depressive disorder. J Clin Psychiatry. 2010; 71(2): 207–18. https://doi.org/10.4088/JCP.09r05947blu
42. R. R. Kulkarni, P. S. Pawar. Artificial Intelligence in Pharmacy. Asian Journal of Pharmacy and Technology. 2023; 13(4): 304-6. doi: 10.52711/2231-5713.2023.00054
43. Vaishnavi Dnyaneshwar Ugale, Gayatri Vilas Uphade, Om Hemant Walzade. Review on Artificial Intelligence in Pharmacy. Asian Journal of Pharmacy and Technology. 2025; 15(2): 189-6. doi: 10.52711/2231-5713.2025.00030
44. Vidya Raju, Jasmine Joy Bell, Merlin. N. J, Shaiju S. Dharan. Anxiety Disorders – A Review. Asian J. Pharm. Res. 2017; 7(4): 217-221. doi: 10.5958/2231-5691.2017.00033.8
45. Hofmann SG, Asnaani A, Vonk IJ, Sawyer AT, Fang A. The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognit Ther Res. 2012; 36(5): 427–40. https://doi.org/10.1007/s10608-012-9476-1
46. Cuijpers P, Karyotaki E, Weitz E, Andersson G. Psychological treatment of generalized anxiety disorder: A meta-analysis. Depress Anxiety. 2016; 33(9): 850–68. https://doi.org/10.1002/da.22512
47. Beck AT, Rush AJ, Shaw BF, Emery G (1979) Cognitive Therapy of Depression. Guilford Press ISBN 978-0898627194.
48. Mohd. Yaqub Khan, Min-hua Chen. Living with Environmental Stress. Asian J. Pharm. Res. 2020; 10(1):31-33. doi: 10.5958/2231-5691.2020.00007.6
49. Kabat-Zinn J (2013) Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. Delta, ISBN 978-0345538936.
50. Goyal M, Singh S, Sibinga EM. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med. 2014; 174(3): 357–68. https://doi.org/10.1001/jamainternmed.2013.13018
51. Hofmann SG, Sawyer AT, Witt AA, Oh D. The Efficacy of Mindfulness-Based Therapy: A Review and Meta-analysis. J Consult Clin Psychol. 2010; 78(2): 169–83. https://doi.org/10.1037/a0018555
52. Farb NA, Anderson AK, Mayberg HS. Minding Our Emotions: Mindfulness Training and Emotion Regulation in Depression. Cognit Emot. 2010; 24(5): 755–61. https://doi.org/10.1080/02699930903569096
53. Sneha Mali, Sanket Rathod, Niraj Kale, Namdeo Shinde. Overview of Nutraceuticals. Asian Journal of Pharmaceutical Research. 2022; 12(1):61-0. doi: 10.52711/2231-5691.2022.00010
54. Sarika S. Lokhande. Role of Nutraceuticals in Various Diseases: A Comprehensive Review. Asian J. Pharm. Res. 2018; 8(4): 236-240. doi: 10.5958/2231-5691.2018.00040.0
55. Yogita R. Indalkar, Nayana V. Pimpodkar, Anita S. Godase, Puja S. Gaikwad. A Compressive Review on the Study of Nanotechnology for Herbal Drugs. Asian J. Pharm. Res. 2015; 5(4): 203-207. doi: 10.5958/2231-5691.2015.00031.3
56. Marx W, Lane M, Hockey M. Nutritional psychiatry: The present state of the evidence. Proc Nutr Soc. 2021; 80(4): 403–12. https://doi.org/10.1017/S0029665121000016
57. Mocking RJT, Harmsen I, Assies J, Koeter MW, Ruhé HG, Schene AH. Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder. Transl Psychiatry. 2016; 6(3): e756. https://doi.org/10.1038/tp.2016.29
58. Papakostas GI. Evidence for S-Adenosyl-L-methionine (SAM-e) for the treatment of major depressive disorder. J Clin Psychiatry. 2009; 70(Suppl 5): 18–22. https://doi.org/10.4088/JCP.8136su1c.05
59. Francesca Borrelli, Angelo A lzzo. Herb–Drug Interactions with St John’s Wort (Hypericum perforatum): an Update on Clinical Observations. AAPS J. 2009; 11(4): 710. doi: 10.1208/s12248-009-9146-8
60. Ng QX, Venkatanarayanan N, Ho CY. Clinical use of Hypericum perforatum (St John’s Wort) in depression: A meta-analysis. J Affect Disord. 2007; 210: 211–21. https://doi.org/10.1016/j.jad.2016.12.048
61. Lopresti AL, Smith SJ, Malvi H, Kodgule R. An investigation into the stress-relieving and pharmacological actions of an ashwagandha (Withania somnifera) extract: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore). 2019; 98(37): e17186. https://doi.org/10.1097/MD.0000000000017186
62. Izzo AA. Interactions between herbs and conventional drugs: Overview of the clinical data. Med Princ Pract. 2012; 21(5): 404–28. https://doi.org/10.1159/000334488
63. Schuch FB, Vancampfort D, Firth J. Physical activity and incident depression: A meta-analysis of prospective cohort studies. Am J Psychiatry 2018; 175(7): 631–48. https://doi.org/10.1176/appi.ajp.2018.17111194
64. Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B. Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev. 2019; 107: 525–39. https://doi.org/10.1016/j.neubiorev.2019.09.040
65. Pascoe MC, Thompson DR, Ski CF. Yoga, mindfulness-based stress reduction and stress-related physiological measures: A meta-analysis. Psychoneuroendocrinology. 2017; 86: 152–68. https://doi.org/10.1016/j.psyneuen.2017.08.008
66. Cramer H, Anheyer D, Saha FJ, Dobos G. Yoga for posttraumatic stress disorder – a systematic review and meta-analysis. BMC Psychiatry. 2018; 18(1): 72. https://doi.org/10.1186/s12888-018-1650-x
67. Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017; 106: 48–56. https://doi.org/10.1016/j.maturitas.2017.09.003
68. Carhart-Harris RL, Goodwin GM. The therapeutic potential of psychedelic drugs: past, present, and future. Neuropsychopharmacology. 2017; 42(11): 2105–13. https://doi.org/10.1038/npp.2017.84
69. Griffiths RR, Johnson MW, Carducci MA. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. J Psychopharmacol. 2016; 30(12): 1181–97. https://doi.org/10.1177/0269881116675513
70. Davis AK, Barrett FS, May DG. Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry 2021; 78(5): 481–9. https://doi.org/10.1001/jamapsychiatry.2020.3285
71. Mithoefer MC, Feduccia AA, Jerome L. MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology (Berl). 2019; 236(9): 2735–45. https://doi.org/10.1007/s00213-019-05249-5
72. Reiff CM, Richman EE, Nemeroff CB. Psychedelics and psychedelic-assisted psychotherapy. Am J Psychiatry. 2020; 177(5): 391–410. https://doi.org/10.1176/appi.ajp.2019.19010035
73. Nutt D, Erritzoe D, Carhart-Harris R. Psychedelic psychiatry’s brave new world. Cell. 2020; 181(1): 24–8. https://doi.org/10.1016/j.cell.2020.03.020
74. Lefaucheur JP, Aleman A, Baeken C. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Clin Neurophysiol. 2020; 131(2): 474–528. https://doi.org/10.1016/j.clinph.2019.11.002
75. Gaynes BN, Lloyd SW, Lux L. Repetitive transcranial magnetic stimulation for treatment-resistant depression: A systematic review and meta-analysis. J Clin Psychiatry. 2014; 75(5): 477–89. https://doi.org/10.4088/JCP.13r08815
76. Aaronson ST, Sears P, Ruvuna F. A 5-year observational study of patients with treatment-resistant depression treated with VNS therapy. J Clin Psychiatry. 2017; 78(1): e1–e9. https://doi.org/10.4088/JCP.15m10134
77. Nemeroff CB, Mayberg HS, Krahl SE. VNS therapy in treatment-resistant depression: Clinical evidence and putative neurobiological mechanisms. Neuropsychopharmacology. 2006; 31(7): 1345–55. https://doi.org/10.1038/sj.npp.1301082
78. Cryan JF, O’Riordan KJ, Cowan CS. The microbiota-gut-brain axis. Physiol Rev. 2009; 99(4): 1877–2013. https://doi.org/10.1152/physrev.00018.2018
79. Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: Interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015; 28(2): 203–9.
80. Foster JA, Neufeld K-AM. Gut–brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013; 36(5): 305–12. https://doi.org/10.1016/j.tins.2013.01.005
81. Wallace CJK, Milev R. The effects of probiotics on depressive symptoms in humans: a systematic review. Ann Gen Psychiatry. 2017; 16:14. https://doi.org/10.1186/s12991-017-0138-2
82. Dinan TG, Stanton C, Cryan JF. Psychobiotics: a novel class of psychotropic. Biol Psychiatry. 2013; 74(10): 720–6. https://doi.org/10.1016/j.biopsych.2013.05.001
83. Clapp M, Aurora N, Herrera L, Bhatia M, Wilen E, Wakefield S() Gut microbiota’s effect on mental health: The gut-brain axis. Clin Pract. 2017; 7(4): 987. https://doi.org/10.4081/cp.2017.987
84. Stahl SM. Mechanism of action of serotonin selective reuptake inhibitors: serotonin receptors and pathways mediate therapeutic effects and side effects. J Affect Disord. 1998; 51(3): 215–35. https://doi.org/10.1016/S0165-0327(98)00221-3
85. Krystal JH, Abdallah CG, Sanacora G. Ketamine: a paradigm shift for depression research and treatment. Neuron. 2019; 101(5): 774–8. https://doi.org/10.1016/j.neuron.2019.02.005
86. Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A. The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cogn Ther Res. 2012; 36(5): 427–40. https://doi.org/10.1007/s10608-012-9476-1
87. Lopresti AL, Hood SD, Drummond PD. A review of lifestyle and psychological factors associated with major depression. J Affect Disord. 2013; 148(1): 12–27. https://doi.org/10.1016/j.jad.2013.01.049
88. Jacka FN, O’Neil A, Opie R. A randomised controlled trial of dietary improvement for adults with major depression (the “SMILES” trial). BMC Med. 2017; 15(1): 23. https://doi.org/10.1186/s12916-017-0791-y
89. Insel TR. The NIMH Research Domain Criteria (RDoC) Project: precision medicine for psychiatry. Am J Psychiatry. 2014; 171(4): 395–7. https://doi.org/10.1176/appi.ajp.2014.14020138
90. Malhi GS, Bell E, Bassett D. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry. 2021; 55(1): 7–117. https://doi.org/10.1177/0004867420979353
91. Kendler KS. Toward a philosophical structure for psychiatry. Am J Psychiatry. 2005; 162(3): 433–40. https://doi.org/10.1176/appi.ajp.162.3.433
92. Kennis M, Gerritsen L, van Dalen M, Williams A, Cuijpers P, Bockting C. Prospective biomarkers of major depressive disorder: a systematic review and meta-analysis. Mol Psychiatry. 2020; 25(2): 321–38. https://doi.org/10.1038/s41380-019-0585-z
93. Insel TR. The NIMH Research Domain Criteria (RDoC) Project: precision medicine for psychiatry. Am J Psychiatry. 2014; 171(4): 395–7. https://doi.org/10.1176/appi.ajp.2014.14020138
94. Malhi GS, Bell E, Bassett D. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry. 2021; 55(1):7–117. https://doi.org/10.1177/0004867420979353
95. Kendler KS. Toward a philosophical structure for psychiatry. Am J Psychiatry. 2005; 162(3): 433–40. https://doi.org/10.1176/appi.ajp.162.3.433
96. Kennis M, Gerritsen L, van Dalen M, Williams A, Cuijpers P, Bockting C. Prospective biomarkers of major depressive disorder: a systematic review and meta-analysis. Mol Psychiatry. 2020; 25(2): 321–38. https://doi.org/10.1038/s41380-019-0585-z
97. Schmidt HD, Shelton RC, Duman RS. Functional biomarkers of depression: diagnosis, treatment, and pathophysiology. Neuropsychopharmacology. 2011; 36(12): 2375–94. https://doi.org/10.1038/npp.2011.151
98. Stetler C, Miller GE. Depression and hypothalamic-pituitary-adrenal activation: a quantitative summary of four decades of research. Psychosom Med. 2011; 73(2): 114–26. https://doi.org/10.1097/PSY.0b013e31820ad12b
99. Bobo WV. The treatment of depression in patients with multiple comorbid medical conditions. Prim Care Companion CNS Disord. 2012; 14(4): PCC.11r01320. https://doi.org/10.4088/PCC.11r01320
100. Osborn TL, Wasil AR, Rodriguez M, Venturo-Conerly KE, Schleider JL, Weisz JR. Brief, web-based interventions for depression: A systematic review and meta-analysis. JAMA Psychiatry. 2020; 77(7): 666–75. https://doi.org/10.1001/jamapsychiatry.2020.0287