Faulty cortisol/serotonin interplay. Psychopathological and biological characterisation of a new, hypothetical depression subtype (SeCA depression)
The hypothesis is proposed of a new subtype of depression named: stressor-precipitated, cortisol-induced, serotonin-related, anxiety/aggression-driven depression (SeCA depression). Biologically, these patients are characterized by impaired 5-HT synthesis and reduced 5-HT1A receptor sensitivity. Under normal conditions these functions proceed marginally; in times of stress they easily fail, due to sustained overproduction of cortisol. Psychopathologically this depression type shows the following characteristics: anxiety and aggression, not mood lowering, heralding a depressive episode; the personality structure shows 'character neurotic' impairments and tolerance for (certain) traumatic life events is low. As specific therapeutic agents selective 5-HT1A agonists and cortisol or CRH antagonists are proposed. Prophylactically, maintenance treatment with 5-HT1A agonists seems indicated as well as psychological interventions to increase the stressor threshold.
van Praag
H M
HM
Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands.
D000374:Aggression / Q000502:physiology; D000818:Animals; D001008:Anxiety Disorders / Q000145:classification / Q000503:physiopathology / Q000523:psychology; D001143:Arousal / Q000502:physiology; D003866:Depressive Disorder / Q000145:classification / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D006854:Hydrocortisone / Q000502:physiology*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D010555:Personality Inventory; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D011985:Receptors, Serotonin / Q000502:physiology; D012701:Serotonin / Q000502:physiology*; D013315:Stress, Psychological / Q000150:complications
D011985:Receptors, Serotonin; D012701:Serotonin; D006854:Hydrocortisone