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Prevalencia, causas y tratamiento de la depresión mayor
Resumen
Resumen
La depresión mayor representa un problema de salud pública debido a su alta prevalencia. La etiología de la depresión es compleja, en ella intervienen factores psicosociales, genéticos, y biológicos. Entre los factores psicosociales, se ha observado que los primeros episodios depresivos aparecen después de algún evento estresante, y el estrés que acompaña al primer episodio produce cambios a largo plazo en la fisiología cerebral. Estos cambios de larga duración pueden producir variaciones a nivel estructural y en el funcionamiento de diferentes áreas cerebrales. Entre los factores genéticos que intervienen en la enfermedad depresiva, se ha reportado que alrededor de 200 genes están relacionados con el trastorno depresivo mayor. Dentro de los factores biológicos, existen evidencias de alteraciones a nivel de neurotransmisores, citosinas y hormonas, cuyas acciones inducen modificaciones estructurales y funcionales en el sistema nervioso central, en el sistema inmunológico y en el sistema endocrino, que incrementan el riesgo de padecer la depresión mayor. A pesar de años de estudio, las bases biológicas de la depresión mayor y el mecanismo preciso de la eficacia antidepresiva siguen siendo poco claras. Los objetivos de la presente revisión son el resumir las principales conclusiones de la literatura clínica y experimental en relación con la etiología del trastorno depresivo mayor.
Palabras clave
Depresión mayor, neurotransmisores, neuroplasticidad, serotonina, norepinefrina, sistema inmune.
Abstract
Major depression represents a public health problem due to its high prevalence. The etiology of major depression is complex because involves psychosocial, genetic, and biological factors. Among psychosocial factors, different studies report that the first depressive episode appear after some stressful event and produces long-term changes in brain physiology. These long-lasting changes produce variations at the structural level and in the functioning of different brain areas. Among the genetic factors involved in depressive illness, it has been reported that about 200 genes are related to major depressive disorder. Within the biological factors, there is an evidence of alterations in the level of neurotransmitters, cytosine’s and hormones, whose actions induces structural and functional modifications in the central nervous system, the immune system and the endocrine system, which increases the risk of suffering major depression. Despite years of study, the biological basis of major depression and precise mechanisms of antidepressant efficacy remain unclear. The objective of the present review is to summarize the main conclusions of the clinical and experimental literature regarding to the etiology of major depressive disorder.
Key words
Major depression, neurotransmitters, neuroplasticity, serotonin, norepinephrine, immune system.
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