Chapter 21 The role of corticotropin-releasing hormone in the pathogenesis of Cushing's disease, anorexia nervosa, alcoholism, affective disorders and dementia

The evidence presented in the chapter proposes that CRH integrates not only the hormonal but also the physiological and behavioral pattern in response to environmental and endogenous challenges perceived as stress and continuous alterations in the fine-tuned neuro-endocrine pathways result in overt psychopathology.

Abstract

This chapter discusses the accumulated data. A broad concept of the role of corticotropin-releasing hormone (CRH) as a mediator of adaptive response to all forms of stress has now emerged. The evidence presented in the chapter proposes that: (1) CRH integrates not only the hormonal but also the physiological and behavioral pattern in response to environmental and endogenous challenges perceived as stress and (2) continuous alterations in the fine-tuned neuro-endocrine pathways result in overt psychopathology, perpetuate clinical symptoms, and may lower the threshold for the development of full-blown clinical syndromes in individuals carrying a genetic risk for psychiatric disorders. The neuroendocrine and behavioral systems are inextricably intertwined. Given this bidirectional loop, distinctions between cause and effect are clearly only useful within a limited experimental context. Keeping this in mind, the ambitious goal of understanding how neural and endocrine systems regulate behavior and how psychopathology develops may yet be achieved.