Depression as a Physiological Disease – Implications for Prevention and Intervention

Dr Chris Stapelberg

While major depressive disorder (MDD) was regarded as a purely psychological disorder in the past, increasing evidence points to physiological mechanisms which contribute to this disorder, but also arise from it.

The same physiological mechanisms also underlie antecedents to depressive disorders, such as stress. Mechanisms such as hypothalamic pituitary adrenal (HPA) axis dysfunction and autonomic dysfunction are implicated not only in MDD, but also in the development of other disease processes which co-occur with depressive illness, such as metabolic syndrome, atherosclerotic changes, inflammatory changes and platelet activation. These changes are in turn implicated in other medical conditions closely linked to MDD, including diabetes, coronary heart disease and stroke.

A greater understanding of these disease mechanisms and their interaction will allow opportunities for disease prevention and early intervention. Viewing MDD as a physiological disease in addition to its adverse psychological impact raises several important issues: These include the recognition of stress and depressed mood as risk factors for developing metabolic changes and cardiovascular disease, and thus the importance of comprehensive medical screening in MDD patients.

Furthermore, the links between diseases like coronary heart disease (CHD) and MDD are reciprocal, putting people with pre-existing CHD at risk of developing depression, which in turn exacerbates CHD. Such reciprocal relationships have further implications for prevention and intervention, and in this context both existing and novel preventative strategies will be discussed.

Dr Chris Stapelberg, Consultant Psychiatrist, Griffith University and Queensland Health will present at the:

13th International Mental Health Conference, "Positive Change -- Investing in Mental Health"  6th to the 8th of August 2012, on the Gold Coast.

Web: http://anzmh.asn.au/conference Email: conference@anzmh.asn.au