Neurológia pre prax 2/2009

Depressive disorders in selected neurological affections

Depressive disorder is one of the most frequently occuring mental disorders. The course of depression is often complicated by relapses, recurrence, chronicity and subsyndromic manifestations. Depressive disorder occurs independently of other somatic or mental conditions. Also, we distinguish so called organic or symptomatic depressive disorder accompanying many somatic disorders and being recognized as the most common neuropsychiatric comorbidity. It often occurs in strokes, Alzheimer´s disease and other dementias, Parkinson´s disease, epilepsy, multiple sclerosis and other neurological disorders. It is well known, clinical features of depressive disorder may markedly differ from these in organic depression. Despite the progress of knowledge, pathogenesis of depression still remains not adequate understood. It is conceptualized as a dysfunction of prefrontal cortex – amygdala/hippocampus – thalamus – basal ganglia circuit in terms of functional neuroanatomy. The modern molecular research aims at disturbances of transnuclear signalization, transcriptional and nerve growth factors and gene expression. Depression is a disorder with complex manifestations of emotivity, affectivity, motivation, cognition and motoric, nerovegetative and endocrine functions. Because of very frequent occurence in neurological disorders, depression could be considered as a prototype of neuropsychiatric disorder, which requires complex strategy in diagnostics, treatment and research.

Keywords: depression, neurological disorders, neuropsychiatry, organic