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

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.