PATOPHYSIOLOGYof mental disorder

Sawiji, S.Kep.Ns.MSc*Phone: 081328028333

E-mail: sawijiamani@gmail.com

DEPARTMENT OF NURSING BASIC SCIENCEMUHAMMADIYAH GOMBONG HEALTH SCIENCE

INSTITUTE

Topic of discussions

1. Stress-HPA axis:a. Increased cortisolb. Effect of high cortisol

2. Structural changes in brain

a. Cortisol is often increased in depressed people

b. Effects of high cortisol levels

Increase cell death in hippocampus Probably due to excitotoxicity Brief cortisol exposure increases hippocampal

activity helps remember acute stressor. Hipp negative feedback on cortisol levels Lengthy high levels increase cell death, also

decrease neurogenesis As a result vicious circle: High cortisol

hipp. excitotoxicity less (-) feedback high cortisol.

Depressed people often have bad memories and difficulty reasoning.

SSRIs increased neurogenesis in hipp., increased memory and reasoning.

Hypothesis: 5-HT &/or NE cAMP CREB BDNF 5-HT4, -6, -7 & β are coupled to Gs

BDNF in rats also increases neurogenesis in hippocampus and decreases behavioral measures of animal “depression.”

2. Structural changes in brain

Hippocampus, amygdala, parahippocamp. Smaller in affected twin (static trait) Disordered hippocampal pyramidal cells

• Correlation between cell disorder and severity• May be due to maternal influenza in 2nd trimester

Also in entorhinal, cingulate, parahippocampal cortex