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Endocrine problems related to mobility

Endocrine problems related to mobility. G.Tolis* MD, PhD,FRCP (GR/Canada) S.Livadas  , N.Angelopoulos  , D.Kaltsas  Division of Endocrinology Metabolism Hippokrateion Hospital, Athens, Greece * Chairman  Fellows. ONE OF THE HISTORICAL DEBATES IN PSYCHIATRY. NATURE vs NURTURE.

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Endocrine problems related to mobility

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  1. Endocrine problems related to mobility G.Tolis* MD, PhD,FRCP (GR/Canada) S.Livadas , N.Angelopoulos , D.Kaltsas  Division of Endocrinology Metabolism Hippokrateion Hospital, Athens, Greece * Chairman Fellows

  2. ONE OF THE HISTORICAL DEBATES IN PSYCHIATRY NATURE vs NURTURE • NATURE: behavior is programmed into the genetic makeup of the individual • NURTURE: behavior is the result of social and environmental influences

  3. The explosion of neuroscience research is transforming conceptual approaches toward mental illness. The dichotomy between mind and brain, or between “nature” and “nurture” is no longer relevant.

  4. Principle :Altered genes do not, by themselves, explain all of the variance of a given major mental illness. Behavior and social factors exert actions on the brain by feeding back upon it to modify the expression of genes and thus the function of nerve cells. Learning, including learning that results in dysfunctional behavior, produces alterations in gene expression. Thus all of "nurture" is ultimately expressed as "nature.” Kandel, ER. A New Intellectual Framework for Psychiatry. American Journal of Psychiatry: Vol. 155(4) 1998, pp 457-469

  5. Mental Health Issues within the Recent Refugee Population: • High number of suicides among young Somali boys and men • Khat / substance abuse among the Somali • Bosnian, Kosovo, Kurdish - Post traumatic stress disorder…

  6. Pressures on the Mental Health of Refugees: a Social Model • Bereavement • Cultural bereavement /Alienation • Problems of communication / language • Socioeconomic factors • Poor housing/poverty

  7. Insecurity / racism • Isolation/break–up of social networks • Unemployment • Generational tensions • Acculturation / loss of status • Loss of recognised role

  8. Hormone Replacement Protocol in Humans : Example The MR/GR Balance Theory deKloet et al., 1999 Memory Performance MR Activation GR Activation facilitation inhibition Dose of administered glucocorticoids

  9. Modulatory Actions of Glucocorticoids and Memory Function in Humans COGNITION COGNITION Placebo Placebo Baseline Day Circulating Cortisol Levels Experimental Day Metyrapone Hydrocortisone

  10. Neuroendocrine responses to Social Interactions Hormone levels can be changed in response to social interactions e.g. sexual interactions; testosterone e.g. dominant/subordinate interaction and stress hormones e.g. Children in day care vs home and stress hormone levels So, by putting the subject in different social Interactions, we might change hormone levels.

  11. Conditioned hormone release If a hormone has been released in a previous situation in which something aversive or negative happened, then encountering this situation again (without the negative event) will automatically induce release of the same hormone E.g. Corticosteroid release in a taste aversion task E.g. Corticosteroid release in a panic attack on a bridge.

  12. Neuroendocrine Responses to cognitive stimuli The way external stimuli are interpreted can trigger hormone secretion E.g. Examination Stress : Depends on the level of mastery felt by individual E.g. Depression : Negative appraisal of environment, increased cortisol secretion

  13. Immune, Endocrine, and Psychological Responses in Civilians Displaced by WarPsychosomatic Medicine 62:502–508 (2000) TABLE 1. Summary of Descriptive Nonparametric Statistics for COR-NEX2 Total Score and 10 Individual Scale Scores Obtained in Displaced Persons vs Nondisplaced Residents • COR-NEX2 total score • Adaptation • Personality disorder • Fear • Depression • Anxiety • Hypersensitivity P<0.00…

  14. Immune, Endocrine, and Psychological Responses in Civilians Displaced by WarPsychosomatic Medicine 62:502–508 (2000) Serum Hormone Levels in Displaced Persons vs Nondisplaced Residents • Cortisol • Prolactin • b-Endorphin P<0.001 P<0.01

  15. Self-reported life event patterns and their relation to health among recently resettled Iraqi and Kurdish refugees in Sweden.Sondergaard HP, Ekblad S, Theorell T. Center for Torture and Trauma Survivors (CTD), Stockholm, Sweden. This paper presents the findings of a longitudinal study of life events in refugees belonging to different language groups from Iraq. Eighty-six individuals were included in the study. Data regarding life events and self-reported health measurements were collected after baseline assessment with 3-monthly intervals on three occasions. Posttraumatic stress disorder was diagnosed by means of a structured interview at baseline. The results indicate that the subjects were influenced to a great extent by political events and the situation of significant others in the home country. Further, the number of negative life events in the host country showed a significant association with self-rated deteriorated health. In subjects with posttraumatic stress disorder, the effects of certain life events were more pronounced. • J Nerv Ment Dis 2001 Dec;189(12):838-45

  16. Auditory Gustatory Olfactory Tactile Visual Supra - Hypothalamic Mesolimbic Hypothalamic- Pituitary Reticular Activating System TRACT VIOLENCE BRAIN STRUCTURE DIS-HARMONY Amygdala-Locus Caeruleus-Hippocampus-Thalamus-Raphe Nucleus DA-NA-5HT-GABA-ACE//CRF-ACTH-ADH-POMC-βΕΝDO-ENCEPHALINS-PRL-GnRH-TRH-LEPTIN-NPY-MSH-GHRS (GHRELIN-PYY)

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