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1 - Models of depression

from Section 1 - Introduction

Published online by Cambridge University Press:  05 May 2013

By
Steven P. Roose ,
Patrick J. McGrath  and
J. John Mann
Edited by
J. John Mann
Edited in association with
Patrick J. McGrath  and
Steven P. Roose
J. John Mann
Affiliation:
Columbia University, New York
Patrick J. McGrath
Affiliation:
Columbia University, New York
Steven P. Roose
Affiliation:
Columbia University, New York
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Summary

This chapter discusses models of unipolar mood disorder that incorporate both current neuroscience and clinical research. Severe major depressive disorder (MDD) is associated with higher basal cortisol secretion and higher peak levels, as well as dexamethasone resistance, indicating failure of feedback inhibition at both the higher stimulated cortisol levels and the lower resting cortisol levels. Post-traumatic stress disorder (PTSD) is associated with lower basal cortisol and increased glucocorticoid receptor (GCR) expression, indicating that the response to stress can be different in different disorders. The fundamental concept of the gene-environment interaction model is that whether a result of genes or early environmental trauma, or both, early life stress results in functional and structural changes in the brain that confer a life-long hyperactive stress response mediated by the hypothalamic pituitary adrenal (HPA) axis. Direct genetic effects or purely environmental effects may result in depressions.
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Information
Clinical Handbook for the Management of Mood Disorders , pp. 1 - 6
Publisher: Cambridge University Press
Print publication year: 2013

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