Clinical and Biochemical Manifestations of Depression

(Second of Two Parts)Neurohormonal HypothesesThe cardinal biologic manifestations of major affective disorder consist of alterations in the hypothalamic centers that govern food intake, libido, circadian rhythms, and the synthesis and release of hypothalamic hormones into hypophysial portal blood and the systemic circulation. Patients with melancholia typically have anorexia, decreased sexual interest, altered timing of the cycle of rest and activity (i.e., early-morning awakening), diurnal variation in mood, and endocrine abnormalities such as hypercortisolism.4, 84 , 85 In a typical depression, the defining characteristics include hyperphagia and hypersomnia.8 The first neuroendocrine investigations into major affective disorder rested on the demonstration that monoaminergic . . .