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Physical Causes of HPA Axis Hyperactivity and Smaller Hippocampus Volumes Linked to Depression in Multiple Sclerosis

Posted on 07. Aug, 2010 by .

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I found this new research to be quite interesting.   Multiple sclerosis (MS) is a disease in which the fatty myelin sheaths around the axons of the brain and spinal cord become damaged.  Depression has been found to be present in nearly 50% of MS sufferers.

It is clear though that the depression is not just a psychological reaction to having the disease.  This is because in patients the depression occurs and it has been found to not be related to how severe one’s MS is and it also can occur at different stages of MS.
Recently researchers at UCLA have showed a physical cause for depression in those patients suffering from MS atrophy of a specific region of the hippocampus which is part of the brain.

The researchers also found a relationship atrophy of the hippocampus and hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. It is believed that the dysregulation of the HPA axis may play a role in the atrophy of the hippocampus and cause depression.

“Depression is one of the most common symptoms in patients with multiple sclerosis,” Gold said. “It impacts cognitive function, quality of life, work performance and treatment compliance. Worst of all, it’s also one of the strongest predictors of suicide.”

The researchers were able to come to these conclusions by examining three regions of the hippocampus in MS patients and comparing them to healthy patients without MS. Further the researches measured cortisol levels which is a stress hormone produced by the HPA axis.

Gold et al.Smaller Cornu Ammonis 2-3/Dentate Gyrus Volumes and Elevated Cortisol in Multiple Sclerosis Patients with Depressive Symptoms. Biological Psychiatry, 2010.

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Medical Students Often Depressed

Posted on 30. Jan, 2009 by .

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New research reveals the extent of how medical students frequently suffer from depression. Sergio Baldassin, from the ABC Regional Medical School, Brazil, led a team of researchers who carried out a study on 481 medical students. He said, “We used cluster analyses to better describe the characteristics of depressive symptoms – affective, cognitive, and somatic. This is the first study to directly evaluate, in a cross-sectional design, the characteristics of depressive symptoms by applying such clusters”.

Affective symptoms represent the core symptoms of a depressive mood, based on students’ reported levels of sadness, dissatisfaction, episodes of crying, irritability and social withdrawal. The cognitive cluster assessed pessimism, sense of failure or guilt, expectation of punishment, dislike of self, suicidal ideation, indecisiveness and change in body image. Finally, the somatic cluster assessed the presence of slowness, insomnia, fatigue, loss of weight and loss of sexual interest. Baldassin said, “There was a high prevalence towards depressive symptoms among medical students, particularly females, mainly involving the somatic and affective clusters”.

The authors’ cluster analysis found that the reasons for most students’ depression scores were in the affective cluster, and that the problem was at its worst in the internship years. Cognitive cluster symptoms were also highest in this year, probably due to feelings of fear and insecurity about entry into the hospital environment. According to Baldassin, “Frequently pre-internship students fear they ‘know nothing’, and are insecure about the physical examination of other people”.

Adapted from materials provided by BMC Medical Education.

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