Psikonöroendokrinolojik Sistemler ve Kronik Psikiyatrik Hastalıklarla İlişkileri
Özet
Metin, psikoloji, endokrinoloji ve sinirbilimini birleştiren psikonöroendokrinolojinin beyin ve hormonal işlevler arasındaki etkileşimleri ve bunların kronik psikiyatrik hastalıklarla (şizofreni, duygudurum bozuklukları, anksiyete) ilişkisini incelemektedir. Şizofrenide dopamin tarafından düzenlenen büyüme hormonu ve prolaktin seviyelerinde tutarsız sonuçlar bulunsa da hastaların farklı endokrinolojik profillere sahip olduğu; ayrıca östrojen ve progesteronun nöroprotektif etkileri ile cinsiyet farklılıklarının hastalık seyrini etkilediği belirtilmektedir. Duygudurum bozukluklarında, depresyon hastalarında hipotalamik-pituiter-adrenal (HPA) ekseninin hiperaktif olduğu ve kortizol salınımının arttığı, tiroid disfonksiyonunun özellikle tedaviye dirençli olgularda önemli olduğu, östrojenin antidepresan, progesteronun ise tam tersi etki gösterdiği; bipolar bozuklukta ise HPA ekseni anormallikleri ile lityum tedavisinin subklinik hipotiroidiye yatkınlık oluşturduğu aktarılmaktadır. Anksiyete bozukluklarında ise CRH ve ACTH sistemlerinin patogenezde rol oynadığı, CRH'nin amigdalayı aktive ederek anksiyete semptomlarını detaylandırdığı, progesteron enjeksiyonunun anksiyolitik etkiler gösterdiği ve hipotalamo-hipofiz-somatotropin eksenindeki anormal yanıtların patolojik belirteç olabileceği vurgulanmaktadır. Sonuç olarak, patolojik endokrin işlevlerin davranışsal bozukluklara yol açtığı ve hormonların kronik psikiyatrik hastalıkların etiyolojisinde önemli bir rol oynadığı kabul edilmektedir.
The text examines the field of psychoneuroendocrinology, which integrates psychology, endocrinology, and neuroscience to study the interactions between brain and hormonal functions and their relationships with chronic psychiatric illnesses such as schizophrenia, mood disorders, and anxiety. In schizophrenia, although inconsistent results exist regarding growth hormone and prolactin levels regulated by dopamine, patients exhibit distinct endocrinological profiles, and the neuroprotective effects of estrogen and progesterone significantly influence the course of the illness across genders. Regarding mood disorders, patients with depression exhibit a hyperactive hypothalamic-pituitary-adrenal (HPA) axis and elevated cortisol, while thyroid dysfunction is prominent in treatment-resistant cases; furthermore, estrogen provides antidepressant effects whereas progesterone opposes it. Bipolar disorder is associated with HPA axis abnormalities, and lithium treatment predisposes patients to subclinical hypothyroidism. In anxiety disorders, CRH and ACTH systems play a critical role in pathogenesis, where CRH enhances anxiety symptoms via amygdala activation, progesterone injection demonstrates anxiolytic effects, and abnormal responses in the somatotropin axis serve as pathological markers. Consequently, pathological endocrine functions lead to behavioral disturbances, and hormones play an essential role in the etiology of chronic psychiatric diseases.
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