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Major Depressive Disorder Is Associated with Impaired Interoceptive Accuracy: A Systematic Review

Faculty Social Work, Health and Nursing, University of Applied Sciences Ravensburg-Weingarten, 88250 Weingarten, Germany
Department of Psychiatry and Psychotherapy I, Ulm University, 88214 Ravensburg (Center for Psychiatry Südwürttemberg), Germany
Drug Commission of the German Medical Association, 10623 Berlin, Germany
Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
Author to whom correspondence should be addressed.
Brain Sci. 2019, 9(6), 131;
Received: 11 April 2019 / Revised: 30 May 2019 / Accepted: 1 June 2019 / Published: 6 June 2019
(This article belongs to the Collection Collection on Clinical Neuroscience)
Interoception is the sense of the physiological condition of the entire body. Impaired interoception has been associated with aberrant activity of the insula in major depressive disorder (MDD) during heartbeat perception tasks. Despite clinical relevance, studies investigating interoceptive impairments in MDD have never been reviewed systematically according to the guidelines of the PRISMA protocol, and therefore we collated studies that assessed accuracy in detecting heartbeat sensations (interoceptive accuracy, IAc) in MDD (databases: PubMed/Medline, PsycINFO, and PsycARTICLES). Out of 389 records, six studies met the inclusion criteria. The main findings suggest that (i) moderately depressed samples exhibit the largest interoceptive deficits as compared with healthy adults. (ii) difficulties in decision making and low affect intensity are correlated with low IAc, and (iii) IAc seems to normalize in severely depressed subjects. These associations may be confounded by sex, anxiety or panic disorder, and intake of selective serotonin reuptake inhibitors. Our findings have implications for the development of interoceptive treatments that might relieve MDD-related symptoms or prevent relapse in recurrent depression by targeting the interoceptive nervous system. View Full-Text
Keywords: major depressive disorder; interoception; heartbeat perception; somatic signals major depressive disorder; interoception; heartbeat perception; somatic signals
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Eggart, M.; Lange, A.; Binser, M.J.; Queri, S.; Müller-Oerlinghausen, B. Major Depressive Disorder Is Associated with Impaired Interoceptive Accuracy: A Systematic Review. Brain Sci. 2019, 9, 131.

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