ABSTRACT
The register of the different moods not only has a heuristic value in the classic description of the manic depressive syndrome done by Emil Kraepelin, but also has a fundamental roll in investigation as well as in clinical treatment of the bipolar disorder, that way becoming an essential tool in the tasks of psychiatrist and psychologist, in charge of patients with mood syndromes. A register of the mood states permits having a graphic and longitudinal vision of the evolution of the mood episodes of patients. This is fundamental for the control of this syndrome whos central characteristic is the reoccurrence of episodes and have diverse clinical presentations, can change its course over time and requires complex therapeutic interventions.
Los registros de los estados de ánimo además de tener un valor heurístico en la descripción clásica de la enfermedad maniaco depresiva realizada por Emil Kraepelin, tienen un rol fundamental tanto en la investigación como en la clínica del trastorno bipolar, siendo una herramienta imprescindible en el quehacer clínico del psiquiatra o psicólogo, que está a cargo de pacientes con enfermedades del ánimo. Un registro de los estados del ánimo permite tener una visión gráfica y longitudinal de la evolución de los episodios anímicos del paciente. Esto es fundamental para el control de esta enfermedad cuya característica central es la recurrencia de episodios y que además posee presentaciones clínicas diversas, puede cambiar su curso a lo largo del tiempo y requerir de intervenciones terapéuticas complejas.
Subject(s)
Humans , Male , Female , Adult , Affect , Bipolar Disorder , Data CollectionABSTRACT
For more than 40 years thyroid hormones and mood disorders have been associated. Some psychiatric symptoms are produced by thyroid illnesses and there is a frequent association of thyroid dysfunction with mood disorders. Therefore, routine thyroid function assessment in patients with mood disorders and the treatment of sub-clinical thyroid dysfunctions is recommended. The usefulness of adding thyroid hormones to antidepressive treatment in euthyroid patients to obtain a potentiation effect has been probed repeatedly. The most common strategy is potentiation with T3, but high doses of T4 have been also used in patients with resistant depression. Thyroid hormones exert their action in the central nervous system through a variety of mechanisms: modulation of gene expression of several groups of proteins, some of them with known physiopathological implications in mood disorders and the influence over serotonin and noradrenergic neurotransmission, known to be one of the modes of action of antidepressants. Finally, it is also important to stress the complex relationship between psychiatric drugs, deiodinases and thyroid hormones, that can potentially help to understand the mechanisms of action of these drugs.