Abstract
SUMMARY Aff ective spectrum disorders include mood and anxiety disorders, whereas the term functional somatic syndromes describes disorders in which the main symptom is chronic pain, with no pathognomonic tissue damage, such as fi bromyalgia, irritable colon, tension headache. Pain as a symptom is often present in patients with depression and anxiety, and similarly, depressed mood, anxiety and other psychiatric symptoms are common in patients with functional somatic syndromes. This explains attitudes that aff ective disorders and functional somatic syndromes should be found along the same spectrum, due to a similar neurobiochemicalmehanism and dysfunction of these CNS structures and neurotransmitter systems, which lead to similar symptoms in both groups. The symptoms of aff ective disorders, including somatic are associated with serotonin and serotonergic transmission in the CNS. The existence of depressive and anxiety disorders, such as fatigue, sleep disorders, cognitive disorders, depressed mood, anxiety, and functional somatic syndromes code indicate a similar mechanism of origin. Hypothesis of central neuropathic pain explains the possibility of the descending inhibitory pain mechanisms, including serotonergic and noradrenergic projections and their receptors. Central suprasegmental senzitization in nociceptive pathways, also at the level of the thalamus and the sensory cortex, trigered by an emotional stressors can cause painful symptoms in both groups of disorders. Serotonergic and noradrenergic pathways and voltage sensitive channels of their receptors are included in the mechanism. Modern psychopharmacology can no longer ignore the existence of painful symptoms in aff ective disorder or depressive and anxiety symptoms in functional somatic syndromes and their treatment can improve. Therapeutic eff ects of SSRI and SNRI antidepressants and alpha 2 delta ligands for all kinds of painful symptoms in aff ective disorders - serotonergic spectrum is expected, due to the impact of the dysfunctional neurotransmission in specifi c regions of the CNS, increasing the effi ciency of information processing and reduction of symptoms.
Highlights
Affective disorders include a wide range of entities, symptoms and syndromes, which are based on the expression of emotion in the broadest clinical sense
The different part of the symptomatology of the various entities associated with dysfunction in serotonergic transmission of any routes that connect the parts of the limbic system, as the nuclei amygdala, hypothalamus and the hippocampus, whether it is in pathways which connect limbic system to the prefrontal cortex,basal ganglia, raphe nuclei and other nucleuses in medulla oblongata,motoneurons in the frontal and lateral horns of the spinal cord
Psychopharmacutics acting on serotonergic transmission in specific regions of the CNS dysfunctional increase the efficiency of information processes in their pathways leading to the reduction of symptoms of affective disorders
Summary
1 «Euromedik» Policlinics, Medical faculty, University in Belgrade, Serbia 2 Special psychiatric ordination «Ramah», Belgrade, Serbia 3 Medical faculty, University in Belgrade, Serbia 4 Clinical Center of Sebia, Belgrade, Serbia
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