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Stress versus depression

F Lechin1, B Van der Dijs, M Benaim

  • 1Section of Neuropharmacology, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.

Progress in Neuro-Psychopharmacology & Biological Psychiatry
|August 1, 1996
PubMed
Summary
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Uncontrollable stress and severe illness in humans share neuroendocrine profiles, distinct from depression. Endogenous and dysthymic depression exhibit opposite neuroendocrine patterns, suggesting different therapeutic strategies.

Area of Science:

  • Neuroendocrinology
  • Psychiatry
  • Stress Physiology

Background:

  • Uncontrollable stress in mammals depletes central noradrenergic activity and causes adrenal hyperactivity, leading to specific peripheral neuroendocrine changes.
  • Severely ill humans exhibit similar peripheral neuroendocrine profiles to stressed mammals, with decreased noradrenaline/adrenaline ratio during stress.
  • Endogenous depressed subjects display an opposite neuroendocrine profile: central noradrenergic hyperactivity and adrenal hyporresponsivity, marked by a significantly increased noradrenaline/adrenaline ratio.

Purpose of the Study:

  • To differentiate neuroendocrine profiles associated with uncontrollable stress, severe illness, endogenous depression, and dysthymic depression.
  • To investigate the distinct physiological and neurochemical markers for these conditions.
  • To propose that these distinct profiles warrant different therapeutic approaches.

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Main Methods:

  • Review and synthesis of existing evidence on neuroendocrine profiles in experimental mammals and human subjects.
  • Analysis of peripheral neuroendocrine markers including catecholamines (noradrenaline, adrenaline, dopamine), cortisol, serotonin, and autonomic nervous system activity (sympathetic and parasympathetic).
  • Comparison of neuroendocrine profiles across different conditions: uncontrollable stress, severe illness, endogenous depression, and dysthymic depression.

Main Results:

  • Uncontrollable stress and severe illness share a profile of reduced noradrenaline/adrenaline ratio and increased free serotonin.
  • Endogenous depression is characterized by high noradrenaline/adrenaline ratio and reduced platelet serotonin, while dysthymic depression shows low resting catecholamines and increased platelet serotonin.
  • Parasympathetic activity is absent in stress/illness but increased in both types of depression.

Conclusions:

  • Three distinct central and peripheral neuroendocrine profiles exist for endogenous depression, dysthymic depression, and maladaptation to stress syndrome.
  • Clinical overlap necessitates differential diagnosis based on neurochemical, neuroendocrine, physiological, metabolic, and neuropharmacological data.
  • The behavioral despair model in mammals is not a valid representation of human depressive syndromes.