An association between hormones and psychiatric disorders has been long recognized, but it is only in the past few decades that we have reached an understanding of the mechanisms underlying this association. A full account of the myriad ways in which the various endocrine systems influence neurobehavioral function would be beyond the scope of a single chapter. We will therefore focus on examples of promising research directions in this area: namely, how the stress and reproductive hormone axes contribute to the pathoetiology of psychiatric conditions, in particular mood and anxiety disorders.
Major depression is considered to be a maladaptive, exaggerated response to stress, and although it is accompanied by abnormalities in multiple endocrine systems, it is the hypothalamic-pituitary-adrenal (HPA) axis that is the main component of the physiological stress response that plays the key role. Stressful life events, particularly those related to loss, have a strong causal relationship with depressive episodes. However, not all people who experience such events develop depression, and an individual's vulnerability to depression depends on the interaction of genetic, developmental, and environmental factors. In addition to the role of the HPA axis in depression, there is growing evidence of HPA axis abnormalities in anxiety disorders and posttraumatic stress disorder (PTSD).
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