nach oben

Der Nervenarzt

Erschienen in:

01.08.2007 | CME Weiterbildung • Zertifizierte Fortbildung

Neue Erkenntnisse zur Pathogenese und Pathophysiologie der Depression

verfasst von: Dr. C. Schüle, T.C. Baghai, R. Rupprecht

Erschienen in: Der Nervenarzt | Sonderheft 3/2007

Einloggen, um Zugang zu erhalten

Zusammenfassung

Mittlerweile gibt es umfangreiche neurobiologische Erkenntnisse zur Pathophysiologie und Pathogenese der Depression, ohne dass diese bislang hinreichend aufgeklärt wurde. Schon lange bekannt sind die Noradrenalin- und Serotoninmangelhypothese im synaptischen Spalt. Weitere Theorien der Depressionsentstehung beinhalten eine Dysfunktion des dopamingeren und GABAergen Systems, eine veränderte Expression von Neuropeptiden wie z. B. Substanz P, neuroimmunologische sowie neuroendokrinologische Ansätze, z. B. die Überaktivität des Hypothalamus-Hypophysen-Nebennierenrinden-Systems. Die Neurotrophin-Hypothese der Depression geht davon aus, dass eine verminderte Produktion neurotropher Faktoren und eine verminderte Neurogenese ein wesentliches pathophysiologisches Korrelat der Depression darstellen. Die verschiedenen pathophysiologischen Konzepte zur Depressionsentstehung haben auch zu neuartigen Therapieansätzen geführt. Allerdings steht der Nachweis für einen erfolgreichen klinischen Einsatz dieser neuen therapeutischen Strategien in der klinischen Praxis noch aus.

Schildkraut JJ (1965) The catecholamine hypothesis of affective disorders: a review of supporting evidence. Am J Psychiatry 122: 509–522PubMed

Coppen A (1967) The biochemistry of affective disorders. Br J Psychiatry 113: 1237–1264PubMed

Shore PA, Silver SL, Brodie BB (1955) Interaction of reserpine, serotonin, and lysergic acid diethylamide in brain. Science 122: 284–285PubMed

Berman RM, Narasimhan M, Miller HL et al. (1999) Transient depressive relapse induced by catecholamine depletion: potential phenotypic vulnerability marker? Arch Gen Psychiatry 56: 395–403PubMed

Garlow SJ, Musselman DL, Nemeroff CB (1999) The neurochemistry of mood disorders: clinical studies. In: Charney DS, Nestler EJ, Bunney BS (eds) Neurobiology of mental illness. Oxford University Press, Oxford, pp 348–364

Delgado PL (2000) Depression: the case for a monoamine deficiency. J Clin Psychiatry [Suppl 6] 61: 7–11

Cheetham SC, Katona CLE, Horton RW (1991) Post-mortem studies of neurotransmitter biochemistry in depression and suicide. In: Horton RW, Katona CLE (eds) Biological aspects of affective disorders. Academic Press, London, UK, pp 192–221

Asberg M, Traskman L, Thoren P (1976) 5-HIAA in the cerebrospinal fluid. A biochemical suicide predictor? Arch Gen Psychiatry 33: 1193–1197PubMed

Mulert C, Juckel G, Brunnmeier M et al. (2007) Prediction of treatment response in major depression: integration of concepts. J Affect Disord 98: 215–225PubMed

10.

Berridge KC, Robinson TE (2003) Parsing reward. Trends Neurosci 26: 507–513PubMed

11.

Roy A, Karoum F, Pollack S (1992) Marked reduction in indexes of dopamine metabolism among patients with depression who attempt suicide. Arch Gen Psychiatry 49: 447–450PubMed

12.

Heinz A (1999) [Anhedonia–a general nosology surmounting correlate of a dysfunctional dopaminergic reward system?]. Nervenarzt 70: 391–398PubMed

13.

Ebert D, Lammers CH (1997) [The central dopaminergic system and depression]. Nervenarzt 68: 545–555PubMed

14.

Lemke MR (1999) [Motor signs of depression]. Nervenarzt 70: 600–612PubMed

15.

Lemke MR, Fuchs G, Gemende I et al. (2004) Depression and Parkinson’s disease. J Neurol [Suppl 6] 251: VI/24–VI/27

16.

Van Putten T, May RP (1978) „Akinetic depression“ in schizophrenia. Arch Gen Psychiatry 35: 1101–1107

17.

Goodwin F, Ebert M, Bunney W (1972) Mental effects of reserpine in men: a review. In: Shader F (ed) Psychiatric complications of medical drugs. Raven, New York, pp 73–101

18.

Wald D, Ebstein RP, Belmaker RH (1978) Haloperidol and lithium blocking of the mood response to intravenous methylphenidate. Psychopharmacology berl) 57: 83–87

19.

Papakostas GI (2006) Dopaminergic-based pharmacotherapies for depression. Eur Neuropsychopharmacol 16: 391–402PubMed

20.

Lemke MR (2007) [Antidepressant effects of dopamine agonists: Experimental and clinical findings]. Nervenarzt 78: 31–38PubMed

21.

Crane GE (1959) Cycloserine as an antidepressant agent. Am J Psychiatry 115: 1025–1026PubMed

22.

Muller N, Schwarz MJ (2007) The immune-mediated alteration of serotonin and glutamate: towards an integrated view of depression. Mol Psychiatry

23.

Calabrese JR, Bowden CL, Sachs GS et al. (1999) A double-blind placebo-controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. J Clin Psychiatry 60: 79–88PubMed

24.

Sanacora G, Gueorguieva R, Epperson CN et al. (2004) Subtype-specific alterations of gamma-aminobutyric acid and glutamate in patients with major depression. Arch Gen Psychiatry 61: 705–713PubMed

25.

Scarr E, Pavey G, Sundram S et al. (2003) Decreased hippocampal NMDA, but not kainate or AMPA receptors in bipolar disorder. Bipolar Disord 5: 257–264PubMed

26.

Nowak G, Ordway GA, Paul IA (1995) Alterations in the N-methyl-D-aspartate (NMDA) receptor complex in the frontal cortex of suicide victims. Brain Res 675: 157–164PubMed

27.

Brambilla P, Perez J, Barale F et al. (2003) GABAergic dysfunction in mood disorders. Mol Psychiatry 8: 721–737, 715PubMed

28.

Rupprecht R (2003) Neuroactive steroids: mechanisms of action and neuropsychopharmacological properties. Psychoneuroendocrinology 28: 139–168PubMed

29.

Rigby M, O’Donnell R, Rupniak NM (2005) Species differences in tachykinin receptor distribution: further evidence that the substance P (NK1) receptor predominates in human brain. J Comp Neurol 490: 335–353PubMed

30.

Stout SC, Owens MJ, Nemeroff CB (2001) Neurokinin(1) receptor antagonists as potential antidepressants. Annu Rev Pharmacol Toxicol 41: 877–906PubMed

31.

Bondy B, Baghai TC, Minov C et al. (2003) Substance P serum levels are increased in major depression: preliminary results. Biol Psychiatry 53: 538–542PubMed

32.

Lieb K, Walden J, Grunze H et al. (2004) Serum levels of substance P and response to antidepressant pharmacotherapy. Pharmacopsychiatry 37: 238–239PubMed

33.

Kramer MS, Cutler N, Feighner J et al. (1998) Distinct mechanism for antidepressant activity by blockade of central substance P receptors. Science 281: 1640–1645PubMed

34.

Keller M, Montgomery S, Ball W et al. (2006) Lack of efficacy of the substance p (neurokinin1 receptor) antagonist aprepitant in the treatment of major depressive disorder. Biol Psychiatry 59: 216–223PubMed

35.

Linnoila M, Cowdry R, Lamberg BA et al. (1983) CSF triiodothyronine (rT3) levels in patients with affective disorders. Biol Psychiatry 18: 1489–1492PubMed

36.

Rupprecht R, Rupprecht C, Rupprecht M et al. (1989) Triiodothyronine, thyroxine, and TSH response to dexamethasone in depressed patients and normal controls. Biol Psychiatry 25: 22–32PubMed

37.

Sullivan PF, Wilson DA, Mulder RT, Joyce PR (1997) The hypothalamic-pituitary-thyroid axis in major depression. Acta Psychiatr Scand 95: 370–378PubMed

38.

Bauer M, Hellweg R, Graf KJ, Baumgartner A (1998) Treatment of refractory depression with high-dose thyroxine. Neuropsychopharmacology 18: 444–455PubMed

39.

Loosen PT, Prange AJ Jr (1982) Serum thyrotropin response to thyrotropin-releasing hormone in psychiatric patients: a review. Am J Psychiatry 139: 405–416PubMed

40.

Amsterdam JD, Fava M, Maislin G et al. (1996) TRH stimulation test as a predictor of acute and long-term antidepressant response in major depression. J Affect Disord 38: 165–172PubMed

41.

Linkowski P, Mendlewicz J, Kerkhofs M et al. (1987) 24-hour profiles of adrenocorticotropin, cortisol, and growth hormone in major depressive illness: effect of antidepressant treatment. J Clin Endocrinol Metab 65: 141–152PubMedCrossRef

42.

Voderholzer U, Laakmann G, Wittmann R et al. (1993) Profiles of spontaneous 24-hour and stimulated growth hormone secretion in male patients with endogenous depression. Psychiatry Res 47: 215–227PubMed

43.

Dinan TG (1998) Psychoneuroendocrinology of depression. Growth hormone. Psychiatr Clin North Am 21: 325–339PubMed

44.

Ehlers CL, Kupfer DJ (1987) Hypothalamic peptide modulation of EEG sleep in depression: a further application of the S-process hypothesis. Biol Psychiatry 22: 513–517PubMed

45.

Rubin RT, Poland RE, Lesser IM (1989) Neuroendocrine aspects of primary endogenous depression VIII. Pituitary-gonadal axis activity in male patients and matched control subjects. Psychoneuroendocrinology 14: 217–229PubMed

46.

Payne JL (2003) The role of estrogen in mood disorders in women. Int Rev Psychiatry 15: 280–290PubMed

47.

Weissman MM, Klerman GL (1977) Sex differences and the epidemiology of depression. Arch Gen Psychiatry 34: 98–111PubMed

48.

Young EA, Midgley AR, Carlson NE, Brown MB (2000) Alteration in the hypothalamic-pituitary-ovarian axis in depressed women. Arch Gen Psychiatry 57: 1157–1162PubMed

49.

Amin Z, Canli T, Epperson CN (2005) Effect of estrogen-serotonin interactions on mood and cognition. Behav Cogn Neurosci Rev 4: 43–58PubMed

50.

Kornstein SG, Schatzberg AF, Thase ME et al. (2000) Gender differences in treatment response to sertraline versus imipramine in chronic depression. Am J Psychiatry 157: 1445–1452PubMed

51.

Halbreich U (2000) Gonadal hormones, reproductive age, and women with depression. Arch Gen Psychiatry 57: 1163–1164PubMed

52.

Schweiger U, Deuschle M, Weber B et al. (1999) Testosterone, gonadotropin, and cortisol secretion in male patients with major depression. Psychosom Med 61: 292–296PubMed

53.

Shores MM, Sloan KL, Matsumoto AM et al. (2004) Increased incidence of diagnosed depressive illness in hypogonadal older men. Arch Gen Psychiatry 61: 162–167PubMed

54.

Pope HG Jr, Cohane GH, Kanayama G et al. (2003) Testosterone gel supplementation for men with refractory depression: a randomized, placebo-controlled trial. Am J Psychiatry 160: 105–111PubMed

55.

Holsboer F (2000) The corticosteroid receptor hypothesis of depression. Neuropsychopharmacology 23: 477–501PubMed

56.

Binder EB, Salyakina D, Lichtner P et al. (2004) Polymorphisms in FKBP5 are associated with increased recurrence of depressive episodes and rapid response to antidepressant treatment. Nat Genet 36: 1319–1325PubMed

57.

Rossum EF van, Binder EB, Majer M et al. (2006) Polymorphisms of the glucocorticoid receptor gene and major depression. Biol Psychiatry 59: 681–688PubMed

58.

Gold PW, Chrousos G, Kellner C et al. (1984) Psychiatric implications of basic and clinical studies with corticotropin-releasing factor. Am J Psychiatry 141: 619–627PubMed

59.

Holsboer F, Von Bardeleben U, Gerken A et al. (1984) Blunted corticotropin and normal cortisol response to human corticotropin-releasing factor in depression. N Engl J Med 311: 1127PubMed

60.

Amsterdam JD, Winokur A, Abelman E et al. (1983) Cosyntropin aCTH alpha 1–24) stimulation test in depressed patients and healthy subjects. Am J Psychiatry 140: 907–909PubMed

61.

Nemeroff CB, Krishnan KR, Reed D et al. (1992) Adrenal gland enlargement in major depression. A computed tomographic study. Arch Gen Psychiatry 49: 384–387PubMed

62.

Rubin RT, Phillips JJ, Sadow TF, McCracken JT (1995) Adrenal gland volume in major depression. Increase during the depressive episode and decrease with successful treatment. Arch Gen Psychiatry 52: 213–218PubMed

63.

Carroll B, Curtis GC, Mendels J (1976) Neuroendocrine regulation in depression. I. Limbic system-adrenocortical dysfunction. Arch Gen Psychiatry 33: 1039–1044PubMed

64.

Arana GW, Baldessarini RJ, Ornsteen M (1985) The dexamethasone suppression test for diagnosis and prognosis in psychiatry. Commentary and review. Arch Gen Psychiatry 42: 1193–1204PubMed

65.

Heuser I, Yassouridis A, Holsboer F (1994) The combined dexamethasone/CRH test: a refined laboratory test for psychiatric disorders. J Psychiatr Res 28: 341–356PubMed

66.

Schule C (2007) Neuroendocrinological mechanisms of actions of antidepressant drugs. J Neuroendocrinol 19: 213–226PubMed

67.

Ising M, Horstmann S, Kloiber S et al. (2007) Combined dexamethasone/corticotropin releasing hormone test predicts treatment response in major depression-a potential biomarker? Biol Psychiatry 62: 47–54PubMed

68.

Zobel AW, Yassouridis A, Frieboes RM, Holsboer F (1999) Prediction of medium-term outcome by cortisol response to the combined dexamethasone-CRH test in patients with remitted depression. Am J Psychiatry 156: 949–951PubMed

69.

Zobel AW, Nickel T, Kunzel HE et al. (2000) Effects of the high-affinity corticotropin-releasing hormone receptor 1 antagonist R121919 in major depression: the first 20 patients treated. J Psychiatr Res 34: 171–181PubMed

70.

Jahn H, Schick M, Kiefer F et al. (2004) Metyrapone as additive treatment in major depression: a double-blind and placebo-controlled trial. Arch Gen Psychiatry 61: 1235–1244PubMed

71.

Jeffcoate WJ, Silverstone JT, Edwards CR, Besser GM (1979) Psychiatric manifestations of Cushing’s syndrome: response to lowering of plasma cortisol. Q J Med 48: 465–472PubMed

72.

Schatzberg AF, Rothschild AJ, Langlais PJ et al. (1985) A corticosteroid/dopamine hypothesis for psychotic depression and related states. J Psychiatr Res 19: 57–64PubMed

73.

DeBattista C, Belanoff J, Glass S et al. (2006) Mifepristone versus placebo in the treatment of psychosis in patients with psychotic major depression. Biol Psychiatry 60: 1343–1349PubMed

74.

Rupprecht R, Baghai TC, Moller HJ (2004) [New developments in pharmacotherapy of depression]. Nervenarzt 75: 273–280PubMed

75.

Duman RS (2002) Synaptic plasticity and mood disorders. Mol Psychiatry [Suppl 1] 7: S29–S34

76.

Eriksson PS, Perfilieva E, Bjork-Eriksson T et al. (1998) Neurogenesis in the adult human hippocampus. Nat Med 4: 1313–1317PubMed

77.

Sheline YI, Wang PW, Gado MH et al. (1996) Hippocampal atrophy in recurrent major depression. Proc Natl Acad Sci U S A 93: 3908–3913PubMed

78.

Sheline YI, Sanghavi M, Mintun MA, Gado MH (1999) Depression duration but not age predicts hippocampal volume loss in medically healthy women with recurrent major depression. J Neurosci 19: 5034–5043PubMed

79.

Thome J, Duman RS, Henn FA (2002) [Molecular aspects of antidepressive therapy. Transsynaptic effects on signal transduction, gene expression and neuronal plasticity]. Nervenarzt 73: 595–599PubMed

80.

Sapolsky RM (2000) Glucocorticoids and hippocampal atrophy in neuropsychiatric disorders. Arch Gen Psychiatry 57: 925–935PubMed

81.

Tuvnes FA, Steffenach HA, Murison R et al. (2003) Selective hippocampal lesions do not increase adrenocortical activity. J Neurosci 23: 4345–4354PubMed

82.

Frodl T, Meisenzahl EM, Zetzsche T et al. (2002) Hippocampal changes in patients with a first episode of major depression. Am J Psychiatry 159: 1112–1118PubMed

83.

Lupien SJ, Leon M de, Santi S de et al. (1998) Cortisol levels during human aging predict hippocampal atrophy and memory deficits. Nat Neurosci 1: 69–73PubMed

84.

Blendy JA (2006) The role of CREB in depression and antidepressant treatment. Biol Psychiatry 59: 1144–1150PubMed

85.

Dowlatshahi D, MacQueen GM, Wang JF, Young LT (1998) Increased temporal cortex CREB concentrations and antidepressant treatment in major depression. Lancet 352: 1754–1755PubMed

86.

Chen AC, Shirayama Y, Shin KH et al. (2001) Expression of the cAMP response element binding protein cREB) in hippocampus produces an antidepressant effect. Biol Psychiatry 49: 753–762PubMed

87.

Laske C, Eschweiler GW (2006) [Brain-derived neurotrophic factor: from nerve growth factor to modulator of brain plasticity in cognitive processes and psychiatric diseases]. Nervenarzt 77: 523–537PubMed

88.

Pawlak R, Nagai N, Urano T et al. (2002) Rapid, specific and active site-catalyzed effect of tissue-plasminogen activator on hippocampus-dependent learning in mice. Neuroscience 113: 995–1001PubMed

89.

Hampton KK, Grant PJ, Boothby M et al. (1990) The effect of modified electroconvulsive therapy on vasopressin release and haemostasis in man. Blood Coagul Fibrinolysis 1: 293–297PubMed

90.

Malberg JE, Eisch AJ, Nestler EJ, Duman RS (2000) Chronic antidepressant treatment increases neurogenesis in adult rat hippocampus. J Neurosci 20: 9104–9110PubMed

91.

Hairston IS, Peyron C, Denning DP et al. (2004) Sleep deprivation effects on growth factor expression in neonatal rats: a potential role for BDNF in the mediation of delta power. J Neurophysiol 91: 1586–1595PubMed

92.

Stewart C, Reid I (1993) Electroconvulsive stimulation and synaptic plasticity in the rat. Brain Res 620: 139–141PubMed

93.

Muller MB, Toschi N, Kresse AE et al. (2000) Long-term repetitive transcranial magnetic stimulation increases the expression of brain-derived neurotrophic factor and cholecystokinin mRNA, but not neuropeptide tyrosine mRNA in specific areas of rat brain. Neuropsychopharmacology 23: 205–215PubMed

94.

Shirayama Y, Chen AC, Nakagawa S et al. (2002) Brain-derived neurotrophic factor produces antidepressant effects in behavioral models of depression. J Neurosci 22: 3251–3261PubMed

95.

Siuciak JA, Altar CA, Wiegand SJ, Lindsay RM (1994) Antinociceptive effect of brain-derived neurotrophic factor and neurotrophin-3. Brain Res 633: 326–330PubMed

96.

Santarelli L, Saxe M, Gross C et al. (2003) Requirement of hippocampal neurogenesis for the behavioral effects of antidepressants. Science 301: 805–809PubMed

97.

Coppell AL, Pei Q, Zetterstrom TS (2003) Bi-phasic change in BDNF gene expression following antidepressant drug treatment. Neuropharmacology 44: 903–910PubMed

98.

Kuroda Y, McEwen BS (1998) Effect of chronic restraint stress and tianeptine on growth factors, growth-associated protein-43 and microtubule-associated protein 2 mRNA expression in the rat hippocampus. Brain Res Mol Brain Res 59: 35–39PubMed

99.

Henn FA, Vollmayr B (2004) Neurogenesis and depression: etiology or epiphenomenon? Biol Psychiatry 56: 146–150PubMed

100.

Conti AC, Cryan JF, Dalvi A et al. (2002) cAMP response element-binding protein is essential for the upregulation of brain-derived neurotrophic factor transcription, but not the behavioral or endocrine responses to antidepressant drugs. J Neurosci 22: 3262–3268PubMed

101.

Smith MA, Makino S, Kim SY, Kvetnansky R (1995) Stress increases brain-derived neurotropic factor messenger ribonucleic acid in the hypothalamus and pituitary. Endocrinology 136: 3743–3750PubMed

102.

Siuciak JA, Lewis DR, Wiegand SJ, Lindsay RM (1997) Antidepressant-like effect of brain-derived neurotrophic factor bDNF). Pharmacol Biochem Behav 56: 131–137PubMed

103.

Takahashi M, Terwilliger R, Lane C et al. (1999) Chronic antidepressant administration increases the expression of cAMP-specific phosphodiesterase 4A and 4B isoforms. J Neurosci 19: 610–618PubMed

104.

Houslay MD (2001) PDE4 cAMP-specific phosphodiesterases. Prog Nucleic Acid Res Mol Biol 69: 249–315PubMedCrossRef

105.

Gonzalez AM, Pascual J, Meana JJ et al. (1994) Autoradiographic demonstration of increased alpha 2-adrenoceptor agonist binding sites in the hippocampus and frontal cortex of depressed suicide victims. J Neurochem 63: 256–265PubMedCrossRef

106.

Garcia-Sevilla JA, Escriba PV, Ozaita A et al. (1999) Up-regulation of immunolabeled alpha2A-adrenoceptors, Gi coupling proteins, and regulatory receptor kinases in the prefrontal cortex of depressed suicides. J Neurochem 72: 282–291PubMed

107.

Ordway GA, Schenk J, Stockmeier CA et al. (2003) Elevated agonist binding to alpha2-adrenoceptors in the locus coeruleus in major depression. Biol Psychiatry 53: 315–323PubMed

108.

Klimek V, Stockmeier C, Overholser J et al. (1997) Reduced levels of norepinephrine transporters in the locus coeruleus in major depression. J Neurosci 17: 8451–8458PubMed

109.

Miller HL, Delgado PL, Salomon RM et al. (1996) Clinical and biochemical effects of catecholamine depletion on antidepressant-induced remission of depression. Arch Gen Psychiatry 53: 117–128PubMed

110.

Yatham LN, Liddle PF, Shiah IS et al. (2000) Brain serotonin2 receptors in major depression: a positron emission tomography study. Arch Gen Psychiatry 57: 850–858PubMed

111.

Sargent PA, Kjaer KH, Bench CJ et al. (2000) Brain serotonin1A receptor binding measured by positron emission tomography with [11C]WAY-100635: effects of depression and antidepressant treatment. Arch Gen Psychiatry 57: 174–180PubMed

112.

Stanley M, Mann JJ (1983) Increased serotonin-2 binding sites in frontal cortex of suicide victims. Lancet 1: 214–216PubMed

113.

Stockmeier CA, Shapiro LA, Dilley GE et al. (1998) Increase in serotonin-1A autoreceptors in the midbrain of suicide victims with major depression-postmortem evidence for decreased serotonin activity. J Neurosci 18: 7394–7401PubMed

114.

Alexopoulos GS (2001) „The depression-executive dysfunction syndrome of late life“: a specific target for D3 agonists? Am J Geriatr Psychiatry 9: 22–29PubMed

115.

Alexopoulos GS (2003) Role of executive function in late-life depression. J Clin Psychiatry (Suppl 14) 64: 18–23

116.

Nemeroff CB, Widerlov E, Bissette G et al. (1984) Elevated concentrations of CSF corticotropin-releasing factor-like immunoreactivity in depressed patients. Science 226: 1342–1344PubMed

117.

Nemeroff CB, Owens MJ, Bissette G et al. (1988) Reduced corticotropin releasing factor binding sites in the frontal cortex of suicide victims. Arch Gen Psychiatry 45: 577–579PubMed

118.

Raadsheer FC, Hoogendijk WJ, Stam FC et al. (1994) Increased numbers of corticotropin-releasing hormone expressing neurons in the hypothalamic paraventricular nucleus of depressed patients. Neuroendocrinology 60: 436–444PubMed

119.

Purba JS, Hoogendijk WJ, Hofman MA, Swaab DF (1996) Increased number of vasopressin- and oxytocin-expressing neurons in the paraventricular nucleus of the hypothalamus in depression. Arch Gen Psychiatry 53: 137–143PubMed

120.

Ribeiro SC, Tandon R, Grunhaus L, Greden JF (1993) The DST as a predictor of outcome in depression: a meta-analysis. Am J Psychiatry 150: 1618–1629PubMed

Titel: Neue Erkenntnisse zur Pathogenese und Pathophysiologie der Depression
verfasst von: Dr. C. Schüle
T.C. Baghai
R. Rupprecht
Publikationsdatum: 01.08.2007
Verlag: Springer-Verlag
Erschienen in: Der Nervenarzt / Ausgabe Sonderheft 3/2007
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-007-2370-5

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Neue Erkenntnisse zur Pathogenese und Pathophysiologie der Depression

Zusammenfassung

Neu in den Fachgebieten Neurologie und Psychiatrie

Chirurginnen und Chirurgen sind stark suizidgefährdet

„Restriktion auf vier Wochen Therapie bei Schlaflosigkeit ist absurd!“

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

Akuter Schwindel: Wann lohnt sich eine MRT?

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Sonderheft 3/2007

Psychotherapie bei chronischer Depression

Zertifizierte Fortbildung zum DGPPN-Kongress 2007

Pharmakotherapie bei therapieresistenter Depression

Neue Versorgungsmodelle in der Depressionsbehandlung

Hirnstimulationsverfahren bei Therapieresistenz

Neu in den Fachgebieten Neurologie und Psychiatrie

Chirurginnen und Chirurgen sind stark suizidgefährdet

„Restriktion auf vier Wochen Therapie bei Schlaflosigkeit ist absurd!“

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

Akuter Schwindel: Wann lohnt sich eine MRT?