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Minerva Psichiatrica 2003 September;44(3):129-34

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: Italian

Depression and endocrine disorders

La Torre D., Pandolfo G., Muscatello M. R. A., Zoccali R.

Depressive disorders occurring during endocrinopathies are studied. Endocrine diseases frequently observed in association with depressive symptomatology are: thyroidal, parathyroidal and adrenal diseases, diabetes mellitus, disorders of prolactin secretion. Depres-sive disorders related to pregnancy and post-partum have not been considered, since they represent physiological changes in hormones. The role of hormones in the neuromodulation of the synthesis, the release and the transmission of the main neurotransmitter systems (serotonin, noradrenaline, dopamine, GABA) are actually under research and represent an interesting issue also in a heuristic sense. Pathological variations in blood circulating hormones influence these systems either by specific receptors for each hormone (thyroidal, sexual, adrenal) located on the cell surface, or by direct interaction with neurotransmitters or by genomic changes that rearrange neuronal firing on different levels. The conclusion is drawn that on several central issues need further studies: the possible reactive nature of the depression during a medical condition, the depressive symptomatology induced by drugs, the role of neurobiological and genetic patterns activated by endocrine diseases as stressors. In this connection, psychiatric counselling plays a fundamental role in improving diagnostic accuracy and sensitivity for targeted psychopharmacological therapies.