Importance of neurobiological mechanisms in depression

We have read the article titled “Association between Socioeconomic Factors and Depression among Cardiovascular Patients Living in Rich Resourced Middle Eastern Country” written by Tam Truong Donnelly with great interest [1]. This article highlights the impact of heterogeneous socioeconomic factors on cardiovascular patients with depression as well as the importance of collaborative management to improve both mental and physical conditions in this population. The author reported that some socioeconomic and demographic factors like unemployment, being full-time homemaker, female sex, and lowmonthly incomewere associatedwith depression in cardiovascular patients. Depression is among the most debilitating disorders worldwide while it is associated with significant disability and low quality of life by its own apart from comorbidities. Although association between socioeconomic factors and depression has been demonstrated, endogenous factors also play a role in the pathophysiology of the disease. According to some authors, endogenous depression is classified as a subtype of depression. Recent studies showed that depression has been associated with neuroendocrinological and neuroinflammatory factors such as immune system dysregulation with increased activity of proinflammatory cytokines, hypothalamic-pituitary–adrenal axis activation resulting in hypercortisolemia, and autonomic system