Endogenous depression

In clinical psychiatric terms, the affective disorders can be subdivided into unipolar and bipolar disorders. Unipolar depression is also known as psychotic depression, endogenous depression, idiopathic depression and major depressive disorder. Bipolar disorder is now recognised as being heterogeneous bipolar disorder I is equivalent to classical manic depressive psychosis, or manic depression, while bipolar disorder II is depression with hypomania (Dean, 2002). Unipolar mania is where periods of mania alternate with periods of more normal moods. Seasonal affective disorder (SAD) refers to depression with its onset most commonly in winter, followed by a gradual remission in spring. Some milder forms of severe depression, often those with an identifiable cause, may be referred to as reactive or neurotic depression. Secondary depression is associated with other illnesses, such as neuro-degenerative or cardiovascular diseases, and is relatively common. 

Major depressive (endogenous) Precipitating life event not adequate for degree of depression. Autonomous (unresponsive to changes in life). May occur at any age (childhood to old age). Biologically determined (family history). About 25% of all depressions. Core depressive syndrome plus "vital" signs abnormal rhythms of sleep, motor activity, libido, appetite. Usually responds specifically to antidepressants or electroconvulsive therapy. Tends to recur throughout life. 

Two recently introduced antidepressants are notable m that they are selective serotonin uptake inhibitors Citalopram (19) is reported to be as effective as amitriptyline m the treatment of endogenous depression [75, 16] Fluoxetine (20) as the hydrochlonde is approved for major depressive disorders mcludmg those with concomitant anxiety Interestmgly, it also appears useful m the treatment of obesity [17]... 

Endogenous depression. A serious melancholic state unrelated to the Individual s exteinal environment. 

The TCAs, such as amitriptyline (Elavil) and dox-epin (Sinequan), inhibit reuptake of norepinephrine or serotonin at the presynaptic neuron. Drug classified as MAOIs inhibit the activity of monoamine oxidase a complex enzyme system that is responsible for breaking down amines. This results in an increase in endogenous epinephrine, norepinephrine and serotonin in the nervous system. An increase in these neurohormones results in stimulation of the CNS. The action of the SSRIs is linked to their inhibition of CNS neuronal uptake of serotonin (a CNS neurotransmitter). The increase in serotonin levels is thought to act as a stimulant to reverse depression. 

Pak, M. A., Haas, H. L., Decking, U. K. Schrader, J. (1994). Inhibition of adenosine kinase increases endogenous adenosine and depresses neuronal activity in hippocampal slices. Neuropharmacology 33 (9), 1049-53. 

Elsenga S., van den Hoofdakker R. H. (1993). Clinical effects of sleep deprivation and clomipramine in endogenous depression. J. Psychiatr. Res. 17, 361-74. 

Carlsson, A., The contribution of drug research to investigating the nature of endogenous depression, Pharmakopsychiatr. Neuropsychopharmakol. 9(1), 2-10, 1976. 

Other taxometrics research has evaluated the validity of theoretical psychopathological subtypes. For example, Haslam and Beck (1994) used CCK procedures to test whether five proposed subtypes of major depression (e.g., endogenous, sociotropic, autonomous) reflect underlying categories. Again, because these theoretical subtypes of depression are not necessarily represented in the DSM, they do not speak directly to psychiatric nosology. 

Steiger A, von Bardeleben U, Herth T, Holsboer F. (1989). Sleep EEG and nocturnal secretion of cortisol and growth hormone in male patients with endogenous depression before treatment and after recovery. J Affect Disord. 16(2-3) 189-95. 

Tejedor-Real P, Mico JA, Maldonado R, Roques BP, Gibert-Rahola J. (1995). Implication of endogenous opioid system in the learned helplessness model of depression. Pharmacol Biochem Behav. 52(1) 145-52. 

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