心境障碍医学培训课件.ppt

* /disease.htm /releases/2006/05/060530090014.htm /BipolarMechanism/2BrainDifferences.htm /media_461539689/brain_activity_in_bipolar_disorder.html * * * * * KEY POINTS: This slide demonstrates the role of BDNF in neuronal generation and growth through the metaphor of sunlight, which is necessary for plant growth The BDNF target gene may be the site of flawed transduction in monoamine receptors Under normal conditions, activation of the BDNF target gene allows BDNF to be produced, exerting a protective role on the development of brain neurons. However, when the BDNF gene is not activated under stressful conditions, BDNF is not produced, and neurons in the hippocampus may atrophy or die This mechanism may be responsible for depression and is consistent with neuroimaging studies that have shown that hippocampal neurons in individuals with MDD are smaller and are functionally impaired These findings suggest that early detection and diagnosis of depression are crucial to ensure optimal clinical and physiological outcomes for patients REFERENCE: Stahl SM. Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. 2nd ed. New York, NY: Cambridge University Press; 2000:187. * experiences in childhood, especially inadequate parenting or loss of a parent, especially the mother. This may lead to lack of confidence and low self-esteem as an adult People with such personalities include the anxious and dependent type, which have long-term difficulties in coping with stress, and obsessional personalities which can find it particularly difficult to adapt to stress or life changes as in work or relationships, and this can ‘come out’ as depression. * 2 years presence of numerous periods of hypomanic symptoms and depressive symptoms that do not meet criterion for a Major Depressive Episode * * KEY POINTS: The likelihood of recovery from MDD decreases as the length of an MDD episode increases Treatments are most likely to be effective, and the probability of r