Major depressive disorder pathophysiology: Difference between revisions
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{{Major depressive disorder}} | {{Major depressive disorder}} | ||
{{CMG}}; {{AE}} {{Mitra}} | |||
==Overview== | |||
The exact pathogenesis of [[major depressive disorder]] is not fully understood. | |||
However, it is thought that [[major depressive disorder]] is the result of decreased levels of [[serotonin]], [[norepinephrine]], and [[dopamine]]. | |||
==Pathophysiology== | |||
*The exact pathogenesis of [[major depressive disorder]] is not completely understood; however, following etiologies have been suggested to play a role in the development of [[major depressive disorder]]. | |||
**'''1. [[Neurotransmitters]]''' | |||
***'''[[Serotonin]]''': [[Serotonin]] depletion has been most commonly shown to be associated with [[depression]]. <ref name="pmid26043325">{{cite journal| author=Cowen PJ, Browning M| title=What has serotonin to do with depression? | journal=World Psychiatry | year= 2015 | volume= 14 | issue= 2 | pages= 158-60 | pmid=26043325 | doi=10.1002/wps.20229 | pmc=4471964 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26043325 }} </ref> For this reason, [[serotonergic agents]] are first-line treatment of [[major clinical depression]]. | |||
***'''[[Norepinephrine]]''': Abnormal [[norepinephrine]] metabolites have been shown in [[blood]], [[urine]], and [[CSF]] in patients with [[major depressive disorder]]. <ref name="pmid21750623">{{cite journal| author=Moret C, Briley M| title=The importance of norepinephrine in depression. | journal=Neuropsychiatr Dis Treat | year= 2011 | volume= 7 | issue= Suppl 1 | pages= 9-13 | pmid=21750623 | doi=10.2147/NDT.S19619 | pmc=3131098 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21750623 }} </ref> [[Serotonin-norepinephrine reuptake inhibitors]] (e.g., [[venlafaxine]]) increase both [[serotonin]] and [[norepinephrine]] levels and are used as the firs-line treatment of [[major depressive disorder]]. | |||
***'''[[Dopamine]]''': [[Major depressive disorder]] may be associated with decreased [[dopaminergic]] activity. <ref name="pmid29106542">{{cite journal| author=Belujon P, Grace AA| title=Dopamine System Dysregulation in Major Depressive Disorders. | journal=Int J Neuropsychopharmacol | year= 2017 | volume= 20 | issue= 12 | pages= 1036-1046 | pmid=29106542 | doi=10.1093/ijnp/pyx056 | pmc=5716179 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29106542 }} </ref> It has been suggested that patients with [[major depressive disorder]] may have dysfunctional [[masolimbic dopamine pathway]] and/or hypoactive [[dopamine D1 receptors]]. Reduced [[dopamine]] concentrations with drugs (e.g. [[reserpine]]) or certain pathologic conditions (e.g. [[Parkinson's disease]]) have been linked to symptoms of depression. In addition, drus increasing [[dopamine]] concentrations, such as [[amphetamine]], [[bupropion]], and [[tyrosine]] can reduce depressive symptoms. | |||
**'''2. [[Psychosocial]]''' | |||
**'''3. [[Cognitive]]''': Cognitive theory of Aaron Beck describes a triad of 1) negative self-view 2) negative interpretation of experience and 3) negative view of future. <ref><ref>{{cite book | last = Beck | first = Aaron | title = Depression : causes and treatment | publisher = University of Pennsylvania Press | location = Philadelphia | year = 2014 | isbn = 9780812290882 }}</ref> | |||
**'''4. [[Learned helplessness]]''': Based on this theory, [[depression]] is linked to an individual's inability to control events. | |||
**'''5. [[Stressful life events]]''': Stressful life events may result in permanent neuronal alterations, subsequently predisposing an individual to [[mood disorders]]. The most often associated life event linked to the development of [[depression]] is losing a parent before age 11. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Psychiatry]] | |||
Latest revision as of 01:38, 27 May 2021
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Major depressive disorder Microchapters |
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Differentiating Major depressive disorder from other Diseases |
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Major depressive disorder pathophysiology On the Web |
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American Roentgen Ray Society Images of Major depressive disorder pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mitra Chitsazan, M.D.[2]
Overview
The exact pathogenesis of major depressive disorder is not fully understood. However, it is thought that major depressive disorder is the result of decreased levels of serotonin, norepinephrine, and dopamine.
Pathophysiology
- The exact pathogenesis of major depressive disorder is not completely understood; however, following etiologies have been suggested to play a role in the development of major depressive disorder.
- 1. Neurotransmitters
- Serotonin: Serotonin depletion has been most commonly shown to be associated with depression. [1] For this reason, serotonergic agents are first-line treatment of major clinical depression.
- Norepinephrine: Abnormal norepinephrine metabolites have been shown in blood, urine, and CSF in patients with major depressive disorder. [2] Serotonin-norepinephrine reuptake inhibitors (e.g., venlafaxine) increase both serotonin and norepinephrine levels and are used as the firs-line treatment of major depressive disorder.
- Dopamine: Major depressive disorder may be associated with decreased dopaminergic activity. [3] It has been suggested that patients with major depressive disorder may have dysfunctional masolimbic dopamine pathway and/or hypoactive dopamine D1 receptors. Reduced dopamine concentrations with drugs (e.g. reserpine) or certain pathologic conditions (e.g. Parkinson's disease) have been linked to symptoms of depression. In addition, drus increasing dopamine concentrations, such as amphetamine, bupropion, and tyrosine can reduce depressive symptoms.
- 2. Psychosocial
- 3. Cognitive: Cognitive theory of Aaron Beck describes a triad of 1) negative self-view 2) negative interpretation of experience and 3) negative view of future.
- 4. Learned helplessness: Based on this theory, depression is linked to an individual's inability to control events.
- 5. Stressful life events: Stressful life events may result in permanent neuronal alterations, subsequently predisposing an individual to mood disorders. The most often associated life event linked to the development of depression is losing a parent before age 11.
- 1. Neurotransmitters
References
- ↑ Cowen PJ, Browning M (2015). "What has serotonin to do with depression?". World Psychiatry. 14 (2): 158–60. doi:10.1002/wps.20229. PMC 4471964. PMID 26043325.
- ↑ Moret C, Briley M (2011). "The importance of norepinephrine in depression". Neuropsychiatr Dis Treat. 7 (Suppl 1): 9–13. doi:10.2147/NDT.S19619. PMC 3131098. PMID 21750623.
- ↑ Belujon P, Grace AA (2017). "Dopamine System Dysregulation in Major Depressive Disorders". Int J Neuropsychopharmacol. 20 (12): 1036–1046. doi:10.1093/ijnp/pyx056. PMC 5716179. PMID 29106542.