There are many complex interrelationships between the endocrine system and the nervous system. Important connections between hormones and mental health have been observed. In this chapter, we briefly explore significant historical aspects of psychoneuroendocrinology and then describe the current classification and physiological systems of the key hormones of the hypothalamus, pituitary, and target organs. The hypothalamic-pituitary-gonadal axis is discussed in some detail, with a focus on the role that estrogen plays in neurotransmitter modulation, particularly in schizophrenia. Next, the role of prolactin, which is a potent dopamine antagonist, is reviewed. Many antipsychotic drugs exert their therapeutic actions by causing hyperprolactinemia; however, there are potential clinical adverse effects with prolonged hyperprolactinemia such as osteoporosis. A section on the hypothalamic-pituitary-adrenal (HPA) axis is included since it is closely regulated by central mechanisms involving the limbic system and hypothalamus, and therefore, it has an important role in people with schizophrenia. A key hormone of the HPA axis is cortisol, and hypercortisolemia may precipitate or exacerbate psychotic symptoms. The thyroid hormones have been studied for many decades, but in more recent times, the relationship of hyperthyroidism to the onset of schizophrenia has increased evidence. In this section, we examine the direct impact of the thyroid axis hormones on the key neurotransmitters implicated in the development of psychosis, namely dopamine, serotonin, and glutamate. We conclude that hormones play a huge role in the development, perpetuation, and prognosis of people with schizophrenia.

Hormones and schizophrenia.

https://repositorio-aberto.up.pt/bitstream/10216/127060/1/10.1097-MD.0000000000011376.pdf

Depression and anxiety in systemic lupus erythematosus: The crosstalk between immunological, clinical, and psychosocial factors

The prevalence of psychological problems is frequent in systemic lupus erythematosus (SLE) patients and appears to be increasing. The current study investigated the relationship among disease parameters, quality of life, and the psychological status in Chinese patients with SLE. A self-report survey design was administered to 170 SLE patients and 210 healthy individuals using the Self-Rating Anxiety Scale, the Self-Rating Depression Scale, and the Short Form 36 health survey (SF-36). Our results showed that 20.3% SLE patients had anxiety, and 32.9% had depression, which were significantly higher than the control group (7.1%, 14.3%, resp.). And there were significant correlations among socioeconomic status (SES), disease activity, and anxiety/depression in SLE patients. Meanwhile, SF-36 analysis results revealed that VT, PF, and RP scales were the most powerful predictors of anxiety of SLE patients, and SLEDAI, VT, PF, SF, and RE domains were significantly accounted for anxiety. In summary, there were significant relationships among disease parameters, quality of life, and anxiety/depression in Chinese SLE patients. Therefore, it is necessary to have psychiatric and psychological evaluations and formulate an integrated approach for managing mental health in Chinese lupus patients, especially those who have high disease activity, low SES, and poor quality of life.

/pdf/the-correlations-of-disease-activity-socioeconomic-status-2sjc3vlgou.pdf

The correlations of disease activity, socioeconomic status, quality of life, and depression/anxiety in Chinese patients with systemic lupus erythematosus.

Thyroid hormones are crucial during development and in the adult brain. Of interest, fluctuations in the levels of thyroid hormones at various times during development and throughout life can impact on psychiatric disease manifestation and response to treatment. Here we review research on thyroid function assessment in schizophrenia, relating interrelations between the pituitary-thyroid axis and major neurosignaling systems involved in schizophrenia's pathophysiology. These include the serotonergic, dopaminergic, glutamatergic, and GABAergic networks, as well as myelination and inflammatory processes. The available evidence supports that thyroid hormones deregulation is a common feature in schizophrenia and that the implications of thyroid hormones homeostasis in the fine-tuning of crucial brain networks warrants further research.

https://repositorium.sdum.uminho.pt/bitstream/1822/22002/1/Santos%20NC_J%20Thyroid%20Research_2012.pdf

Revisiting Thyroid Hormones in Schizophrenia

The use of glucocorticoids in systemic lupus erythematosus. After 60 years still more an art than science

Psychiatric symptoms have been reported quite frequently in certain thyroid diseases, but more frequently in association with hypothyroidism. Thyrotoxicosis can be associated with various psychiatric symptoms, such as emotional lability, anxiety, restlessness and rarely frank psychosis. Psychotic symptoms in the context of hyperthyroidism typically present as an affective psychosis. The link between psychosis and hyperthyroidism is poorly understood. Because of this association of psychiatric symptoms is important to exclude a somatic cause, when assessing a patient first. We present the case of young woman who was followed over 2 years and who initially presented to psychiatric consultation for depressive symptoms, after being diagnosed with hyperthyroidism and specific therapy instituted, but who developed psychotic symptoms.

Hyperthyroidism--cause of depression and psychosis: a case report.

Many patients with chronic illnesses suffer from clinical depression (with percentages reported by clinical studies ranging from 15 to 60); even depression is more common in people with chronic medical illnesses, (e.g. Systemic Lupus Erythematosus) than in the general population. However, not every patient with a chronic illness suffers from depression. It is well known that some people think the persons who suffer from a chronic illness have a reason to be depressed, so, there is no need to go to a psychiatrist for treatment. The fact is that not only the medical condition can be the cause for depression and, not always, the treatment for a medical illness can supply the treatment for depression. The condition of clinical depression, associated with a chronic illness, needs to be early diagnosed and early treated because it can worsen the medical state. Systemic Lupus Erythematosus (SLE) is a chronic, autoimmune disease, which affects many organs and systems. The link between lupus and depression is controversial but it is known that negative life events, lupus activity and the treatment for disease may be capable of contributing to clinical depression. We present the case of a young woman who was diagnosed with Systemic Lupus Erythematosus and who initially presented in the psychiatric department for depressive symptoms. The case raised problems in terms of diagnosis, treatment, etiology and prognosis.

Elena Alina Nica

Papers

Hyperthyroidism--cause of depression and psychosis: a case report.

Depression as an initial feature of systemic lupus erythematosus? A case report.

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