Depression: from psychopathology to pathophysiology

• Depression involves cognitive biases, negative schemata, and over-general processing.
• We describe the cortico-limbic structures implicated in those cognitive processes.
• These are the same brain structures that show altered functioning during depression.
• Hence, an integrated model of the psychopathology and pathophysiology of depression.

Major depression is a psychiatric disorder with high prevalence. Both specialists in cognitive psychopathology and neurobiologists have proposed explanations of the process/systems that exhibit altered functioning during this disorder. Psychological processes that are dysfunctional in depressed patients include alterations in self-referential schemas, cognitive biases, ruminations and processing mode (over-general versus concrete). These cognitive processes are associated with altered function of specific brain systems, including prefrontal areas and cingulate cortex (both involved in self-referential processes and rumination), amygdala (cognitive bias), lateral habenula (cognitive bias) and hippocampus (cognitive bias and overgeneral processing). This review aims to present a coherent view integrating these two approaches in a unique model.