Endogenous depression

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Endogenous Depression is an atypical sub-class of the mood disorder, major depressive disorder (clinical depression). Endogenous depression includes patients with treatment-resistant, non-psychotic, major depressive disorder, characterized by abnormal behavior of the endogenous opioid system but not the monoaminergic system.[1][2]


Endogenous depression was initially considered valuable as a means of diagnostic differentiation with reactive depression. While the latter's onset could be attributed to adverse life events and treated with talk therapy, the former would indicate treatment with antidepressants.[3] Indeed, this view of endogenous depression is at the root of the popular view that mood disorders are a reflection of a 'chemical imbalance' in the brain. More recent research has shown that the probability of an endogenous depression patient experiencing an adverse life event prior to a depressive episode is roughly the same as for a reactive depression patient and the efficacy of antidepressant therapy bears no statistical correlation with the patient's diagnostic classification along this axis.[4]

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  1. ^ Nyhuis-P-W, Specka-M, Gastpar-M (2006). "Does the antidepressive response to opiate treatment describe a subtype of depression?". European Neuropsychopharmacology 16 (S4). doi:10.1016/S0924-977X(06)70328-5. 
  2. ^ Bodkin, JA; Zornberg, GL; Lukas, SE; Cole, JO (February 1995). "Harvard Medical School Clinical Study "Buprenorphine treatment of refractory depression."". Journal of Clinical Psychopharmacology 15 (1): 49–57. doi:10.1097/00004714-199502000-00008. PMID 7714228. 
  3. ^ Kramer, T (2002). "Endogenous Versus Exogenous: Still Not the Issue". Medscape Psychopharmacology Today. 7 1. 
  4. ^ Watkins, JT; Leber WR; Imber SD; Collins JF; Elkin I; Pilkonis PA; Sotsky SM; Shea MT; Glass DR (1993). "Temporal Course Of Change Of Depression". Journal of Consulting & Clinical Psychology. 5 61 (858): 64. doi:10.1037/0022-006x.61.5.858. 

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