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Journal article

Pathophysiology of depression: do we have any solid evidence of interest to clinicians?

  • Hasler G Psychiatric University Hospital, University of Berne, Bolligenstrasse 111, 3000 Berne 60, Switzerland.
  • 2010-10-27
Published in:
  • World psychiatry : official journal of the World Psychiatric Association (WPA). - 2010
Depression
GABA
dopamine
genetics
glutamate
neuroimaging
norepinephrine
pathophysiology
serotonin
stress
English Due to the clinical and etiological heterogeneity of major depressive disorder, it has been difficult to elucidate its pathophysiology. Current neurobiological theories with the most valid empirical foundation and the highest clinical relevance are reviewed with respect to their strengths and weaknesses. The selected theories are based on studies investigating psychosocial stress and stress hormones, neurotransmitters such as serotonin, norepinephrine, dopamine, glutamate and gamma-aminobutyric acid (GABA), neurocircuitry, neurotrophic factors, and circadian rhythms. Because all theories of depression apply to only some types of depressed patients but not others, and because depressive pathophysiology may vary considerably across the course of illness, the current extant knowledge argues against a unified hypothesis of depression. As a consequence, antidepressant treatments, including psychological and biological approaches, should be tailored for individual patients and disease states. Individual depression hypotheses based on neurobiological knowledge are discussed in terms of their interest to both clinicians in daily practice and clinical researchers developing novel therapies.
Language
  • English
Open access status
bronze
Identifiers
Persistent URL
https://roar.hep-bejune.ch/global/documents/284646
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