Conclusion

In this chapter we have reviewed ways in which hormonal systems may be altered in psychiatric disorders that may be linked to the pathoetiology of the disorders. The evidence is strongest for the HPA system, which has been implicated in at least two disorders, depression and PTSD, both disorders clearly linked to stress-based etiologies. The evidence for abnormalities in reproductive hormones is still small, but this is a subject of continued investigation. Most notably, abnormalities of reproductive hormones have not been found in PMDD, the disorder most responsive to changing reproductive hormone milieu. Finally, hormones can be used as markers of the functioning of CNS neurotransmitters or receptors, as is the case for GH. As neuroimaging ligands are developed to directly measure these receptors, the latter role of neuroendocrinology may be useful. Many of the critical hormones, like cortisol and estradiol, regulate many other critical neurotransmitter systems, such as serotonin, as well as regulating gene transcription. The area of psychoneuroendocrinology continues to expand, and in combination with the major advances occurring throughout the field of psychiatry, it will become possible to identify the genetic and molecular mechanisms involved in psychiatric disorders, thereby leading to the development of better treatments.

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