(A) Enzyme-linked immunosorbent assessment of in-vivo levels of phosphorylation of IRS-1 (pSer-IRS-1) in L1CAM+ exosomes in subjects in depressive episode during study participation (n=64) as compared to controls (n=29). These data shows a sex-specific increase of pSer-IRS-1 in L1CAM+ exosomes with mean concentrations higher in women with MDD, but not men, as compared to sex-matched controls (Men (blue): p=0.3, HC: 35.1*10–7ng/mL ±1.7, n=15; MDD: 38.1*10–7ng/mL ±2.3, n=23. Women (pink): p=0.02, HC: 31.5*10–7ng/mL ±1.8, n=14; MDD: 37.6*10–7ng/mL ±1.8, n=40). Sex was not reported for 1 subject. (B) Increased in-vivo pSer-IRS-1 levels in women who exhibit greater severity of depressive symptoms. Regression analysis between pSer-IRS-1 concentrations and depression severity of depressive symptoms as assessed at the HDRS-21. Regression line is indicated in dark pink. * indicates significant comparisons with controls. Dashed bars indicate group mean.