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Originalia

Pathophysiologische und neuropsychologische Aspekte depressiver Störungen

Published Online:September 01, 2006https://doi.org/10.1024//1016-264X.12.4.264

Abstract

Zusammenfassung: Bei depressiven Störungen sind zahlreiche neurobiologische Auffälligkeiten dokumentiert. Aufschluß darüber geben Untersuchungen bei primärer Depression sowie Untersuchungen bei depressiven Störungen, die sich im Zusammenhang mit Hirnschädigungen, wie etwa Schlaganfällen, manifestieren. Ebenfalls lassen neuropsychologische Befunde Rückschlüsse auf pathophysiologische Mechanismen zu. Vieles deutet darauf hin, daß es bei depressiven Störungen zu einer Störung eines komplexen neuronalen Netzwerkes kommt, insbesondere unter Beteiligung präfrontaler cortikaler Strukturen, der Amygdala und der Basalganglien sowie ihrer monoaminergen Afferenzen aus Hirnstamm und pontinem Tegmentum. Der Befund eines reduzierten Hippokampusvolumens bei Subtypen der Depression geht möglicherweise auf einen Hypercortisolismus zurück. Neurobiologische Auffälligkeiten stellen einen wichtigen Anknüpfungspunkt für antidepressive Therapien dar. Insgesamt ist die Depression als eine psychobiologische Störung konzeptualisierbar, bei der biologische und psychologische Faktoren eng miteinander verzahnt sind.


Pathophysiological and Neuropsychological Aspects of Depressive Disorders

In depression many neurobiological abnormalities were found. Empirical evidence is drawn from studies in primary and poststroke depression. Additionally, neuropsychological findings give insight into pathophysiological mechanisms. These studies suggest the dysfunction of a complex neural network including prefrontal cortical areas, the amygdala, the basal ganglia, and monoaminergic afferences from the brain stem and tegmentum. The finding of a reduced hippocampus size was attributed to hypercortisolism in some subtypes of depressive disorders. These neurobiological abnormalities are important connecting links for antidepressive therapies. In general, depression has to be conceptualized as a psychobiological dysfunction in which biological and psychological factors are closely related.

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