Población y Salud en Mesoamérica ISSN electrónico: 1659-0201

OAI: https://revistas.ucr.ac.cr/index.php/psm/oai
La depresión mayor en Costa Rica: aspectos epidemiológicos y psicobiológicos
PDF
HTML
EPUB
XML

Palabras clave

Depression
Prevalence
Psychobiologic factors
Environmental enrichment
Depresión
Prevalencia
Factores psicobiológicos
Enriquecimiento ambiental

Cómo citar

Sequeira Cordero, A., Blanco-Vargas, M., & Brenes, J. C. (2021). La depresión mayor en Costa Rica: aspectos epidemiológicos y psicobiológicos. Población Y Salud En Mesoamérica, 19(2). https://doi.org/10.15517/psm.v19i2.48038

Resumen

Introducción: la depresión mayor es uno de los trastornos mentales más comunes y una de las principales causas de discapacidad en el mundo, con una prevalencia que ha aumentado en las últimas décadas. El objetivo de este ensayo es presentar datos epidemiológicos, así como revisar brevemente los mecanismos psicobiológicos de la depresión relacionados con el estrés crónico. Finalmente, discutiremos algunas estrategias para prevenirla y/o tratarla. Proposición: ciertos tratamientos alternativos complementarios a la medicación y psicoterapia podrían ser mucho más eficaces para evitar y mitigar los efectos del estrés crónico y el riesgo de padecer depresión. Argumentos para la discusión: el estrés crónico puede precipitar un episodio depresivo debido a la hiperactividad de la amígdala y del eje hipotalámico-hipofisario-suprarrenal (HHS), la falla en los mecanismos de retrocontrol negativo del HHS, la depleción de monoaminas, la disminución en los niveles de neurotrofinas, el aumento en la excitotoxicidad glutamatérgica, la reducción en la neurogénesis hipocampal, la disfunción de la corteza prefrontal y una respuesta inflamatoria excesiva. Conclusiones: la acumulación crónica de estresores psicosociales sobre los que se tiene poco control, más el sedentarismo, una mala alimentación y pocos espacios de esparcimiento le confieren a nuestro estilo de vida actual un alto potencial depresogénico. Actividades que incluyan ejercicio, interacciones sociales significativas, actividades recreativas, exposición a ambientes naturales, una dieta balanceada y rutinas saludables representarían una estrategia altamente eficaz para el manejo de la depresión y el mejoramiento de la salud integral.

https://doi.org/10.15517/psm.v19i2.48038
PDF
HTML
EPUB
XML

Citas

American Psychiatric Association (APA). (2014). Manual diagnóstico y estadístico de los trastornos mentales DSM-5. (5a. ed.). Editorial Médica Panamericana.

American Psychiatric Association (APA). (2011). (3 de noviembre del 2021). Stress and gender. https://www.apa.org/news/press/releases/stress/2011/gender

Araya Solís, M., Pérez Retana, M. y Quirós Maroto, O. (2020). Caracterización de la población usuaria y de los diagnósticos de la consulta individual de enfermería en salud mental, del Área de Salud San Sebastián-Paso Ancho, Costa Rica. Población y Salud en Mesoamérica, 17(2), 43-58. doi:10.15517/PSM.V17I2.39800

Brenes, J. C., Fornaguera, J. y Sequeira-Cordero, A. (2020). Environmental enrichment and physical exercise attenuate the depressive-like effects induced by social isolation stress in rats. Frontiers in Pharmacology, 11(804). doi:10.3389/fphar.2020.00804

Bueno-Notivol, J., Gracia-García, P., Olaya, B., Lasheras, I., López-Antón, R. y Santabárbara, J. (2021). Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. International journal of clinical and health psychology: IJCHP, 21(1), 100196. https://doi.org/10.1016/j.ijchp.2020.07.007

Carazo Vargas, E., Ortega, R., Arias LeClaire, H., González García, N., González Sánchez, A. y Villegas Barahona, G. (2021). Salud mental y relaciones con el entorno en tiempos de COVID-19 [Informe de Investigación]. Universidad Estatal a Distancia.

Catena-Dell'Osso, M., Fagiolini, A., Marazziti, D., Baroni, S. y Bellantuono, C. (2013). Non-monoaminergic targets for the development of antidepressants: focus on neuropeptides. Mini-Reviews in Medical Chemistry, 13(1), 2-10. doi:10.2174/1389557511307010002

Centers for Disease Control and Prevention. Strategies for Classroom Physical Activity in Schools. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2018.

Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., … Geddes, J. R. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet, 391(10128), 1357–1366. doi:10.1016/S0140-6736(17)32802-7

Clasificación Internacional de Enfermedades (CIE). (20 de julio de 2021). 11a revisión. https://icd.who.int/es

COVID-19 Mental Disorders Collaborators. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet (London, England), S0140-6736(21)02143-7. Advance online publication. https://doi.org/10.1016/S0140-6736(21)02143-7

de Assis, G. G. y Gasanov, E. V. (2019). BDNF and Cortisol integrative system - Plasticity vs. degeneration: Implications of the Val66Met polymorphism. Frontiers in Neuroendocrinology, 55(100784). doi:10.1016/j.yfrne.2019.100784

Depression and Bipolar Support Alliance (DBSA). (27 de julio de 2021). Depression Statistics. https://www.dbsalliance.org/education/depression/statistics/

Docherty, J. P. y Streeter, M. J. (1993). Progress and limitations in psychotherapy research: a focus on depression. The Journal of Psychotherapy Practice and Research, 2(2), 100–118. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330329/pdf/100.pdf

Duman, R. S., Aghajanian, G. K., Sanacora, G. y Krystal, J. H. (2016). Synaptic plasticity and depression: new insights from stress and rapid-acting antidepressants. Nature Medicine, 22(3), 238–249. doi:10.1038/nm.4050

Duman, R. S., Deyama, S. y Fogaça, M. V. (2021). Role of BDNF in the pathophysiology and treatment of depression: Activity-dependent effects distinguish rapid-acting antidepressants. European Journal of Neuroscience, 53(1), 126–139. doi:10.1111/ejn.14630

Eriksson, P. S., Perfilieva, E., Björk-Eriksson, T., Alborn, A. M., Nordborg, C., Peterson, D. A. y Gage, F. H. (1998). Neurogenesis in the adult human hippocampus. Nature Medicine, 4(11), 1313-1317. doi:10.1038/3305

Farah, W. H., Alsawas, M., Mainou, M., Alahdab, F., Farah, M. H., Ahmed, A. T., … LeBlanc, A. (2016). Non-pharmacological treatment of depression: a systematic review and evidence map. Evidence-Based Medicine, 21(6), 214–221. doi: 10.1136/ ebmed-2016-110522

Felger, J. C. y Lotrich, F. E. (2013). Inflammatory cytokines in depression: neurobiological mechanisms and therapeutic implications. Neuroscience, 246, 199-229. doi:10.1016/j.neuroscience.2013.04.060

Flügge, G., Van Kampen, M. y Mijnster, M. J. (2004). Perturbations in brain monoamine systems during stress. Cell and Tissue Research, 315(1), 1-14. doi:10.1007/s00441-003-0807-0

Freeman, A., Tyrovolas, S., Koyanagi, A., Chatterji, S., Leonardi, M., Ayuso-Mateos, J. L., … Haro, J. M. (2016). The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe). BMC Public Health, 16(1098). doi:10.1186/s12889-016-3638-0

Gartlehner, G., Wagner, G., Matyas, N., Titscher, V., Greimel, J., Lux, L., … Lohr, K. N. (2017). Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews. BMJ Open, 7(6). doi:10.1136/bmjopen-2016-014912

GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 392(10159), 1789-1858. doi:10.1016/S0140-6736(18)32279-7

Gómez-Pinilla, F. (2008). Brain foods: the effects of nutrients on brain function. Nat Rev Neurosci, 9(7), 568-578. doi:10.1038/nrn2421

Hanson, N. D., Owens, M. J. y Nemeroff, C. B. (2011). Depression, antidepressants, and neurogenesis: a critical reappraisal. Neuropsychopharmacology, 36, 2589-2602. doi:10.1038/npp.2011.220

Hayashi, T., Noguchi, T., Kubo, Y., Tomiyama, N., Ochi, A. y Hayashi, H. (2021). Social frailty and depressive symptoms during the COVID-19 pandemic among older adults in Japan: Role of home exercise habits. Archives of gerontology and geriatrics, 98, 104555. Advance online publication. https://doi.org/10.1016/j.archger.2021.104555

Herman, J. P., McKlveen, J. M., Ghosal, S., Kopp, B., Wulsin, A., Makinson, R. y Myers, B. (2016). Regulation of the hypothalamic-pituitary-adrenocortical stress response. Comprehensive Physiology, 6(2), 603-621. doi:10.1002/cphy.c150015

Hidaka, B. H. (2012). Depression as a disease of modernity: explanations for increasing prevalence. Journal of Affective Disorders, 140(3), 205-214. doi:10.1016/j.jad.2011.12.036

Hu, S., Tucker, L., Wu, C. y Yang, L. (2020). Beneficial Effects of Exercise on Depression and Anxiety During the Covid-19 Pandemic: A Narrative Review. Frontiers in Psychiatry, 11. doi:10.3389/fpsyt.2020.587557

Instituto Nacional de Estadística y Censos (INEC). (20 julio de 2021). Estimaciones y proyecciones de población. https://www.inec.cr/poblacion/estimaciones-y-proyecciones-de-poblacion

Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M. y Stubbs, B. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience and Biobehavioral Reviews, 107, 525-539. doi:10.1016/j.neubiorev.2019.09.040

Kapur, S. y Mann, J. J. (1992). Role of the dopaminergic system in depression. Biological Psychiatry, 32(1), 1-17. doi:10.1016/0006-3223(92)90137-o

Kendall, K. M., Van Assche, E., Andlauer, T., Choi, K. W., Luykx, J. J., Schulte, E. C. y Lu, Y. (2021). The genetic basis of major depression. Psychological Medicine, 8, 1-14. doi:10.1017/S0033291721000441

Kendler, K. S., Kessler, R. C., Walters, E. E., MacLean, C., Neale, M. C., Heath, A. C. y Eaves, L. J. (1995). Stressful life events, genetic liability, and onset of an episode of major depression in women. The American Journal of Psychiatry, 152(6), 833-842. doi:10.1176/ajp.152.6.833

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R. y Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. doi:10.1001/archpsyc.62.6.593

Kowiański, P., Lietzau, G., Czuba, E., Waśkow, M., Steliga, A. y Moryś, J. (2018). BDNF: A Key Factor with Multipotent Impact on Brain Signaling and Synaptic Plasticity. Cellular and Molecular Neurobiology, 38(3), 579-593. doi:10.1007/s10571-017-0510-4

Labaka, A., Goñi-Balentziaga, O., Lebeña, A. y Pérez-Tejada, J. (2018). Biological Sex Differences in Depression: A Systematic Review. Biological Research for Nursing, 20(4), 383-392. doi:10.1177/1099800418776082

Lai, J. S., Hiles, S., Bisquera, A., Hure, A. J., McEvoy, M. y Attia, J. (2014). A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults. The American Journal of Clinical Nutrition, 99(1), 181-197. doi:10.3945/ajcn.113.069880

Levine, S. (2000). Influence of psychological variables on the activity of the hypothalamic-pituitary-adrenal axis. European Journal of Pharmacology, 405(1-3),149-160. doi:10.1016/s0014-2999(00)00548-3

Lim, G. Y., Tam, W. W., Lu, Y., Ho, C. S., Zhang, M. W. y Ho, R. C. (2018). Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Scientific Reports, 8(1), 2861. doi:10.1038/s41598-018-21243-x

Liu, Y., Zhao, J. y Guo, W. (2018). Emotional Roles of Mono-Aminergic Neurotransmitters in Major Depressive Disorder and Anxiety Disorders. Frontiers in Psychology, 9, 2201. doi:10.3389/fpsyg.2018.02201

Liu, Y. Z., Wang, Y. X. y Jiang, C. L. (2017). Inflammation: The Common Pathway of Stress-Related Diseases. Frontiers in Human Neuroscience, 11, 316. doi:10.3389/fnhum.2017.00316

Lum, K. J., & Simpson, E. (2021). The impact of physical activity on psychological well-being in women aged 45-55 years during the Covid pandemic: A mixed-methods investigation. Maturitas, 153, 19–25. https://doi.org/10.1016/j.maturitas.2021.07.012

Lupien, S. J., McEwen, B. S., Gunnar, M. R. y Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews. Neurosicence, 10(6), 434-445. doi:10.1038/nrn2639

Luscher, B., Shen, Q. y Sahir, N. (2011). The GABAergic deficit hypothesis of major depressive disorder. Molecular Psychiatry, 16(4), 383-406. doi:10.1038/mp.2010.120

Mathers, C., Ma Fat, D., Boerma, J. T. y World Health Organization. (2008). The global burden of disease: 2004 update. World Health Organization.

Maughan, B., Collishaw, S. y Stringaris, A. (2013). Depression in Childhood and Adolescence. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(1), 35-40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3565713/pdf/ccap22_1p0035.pdf

Maydych, V. (2019). The Interplay Between Stress, Inflammation, and Emotional Attention: Relevance for Depression. Frontiers in Neuroscience, 13, 384. doi:10.3389/fnins.2019.00384

Melo, H. M., Santos, L. E. y Ferreira, S. T. (2019). Diet-Derived Fatty Acids, Brain Inflammation, and Mental Health. Frontiers in Neuroscience, 13, 265. doi:10.3389/fnins.2019.00265

Micheli, L., Ceccarelli, M., D'Andrea, G. y Tirone, F. (2018). Depression and adult neurogenesis: Positive effects of the antidepressant fluoxetine and of physical exercise. Brain Research Bulletin, 143, 181–193. doi:10.1016/j.brainresbull.2018.09.002

Mikasova, L., Xiong, H., Kerkhofs, A., Bouchet, D., Krugers, H. J. y Groc, L. Stress hormone rapidly tunes synaptic NMDA receptor through membrane dynamics and mineralocorticoid signalling. Scientific Reports, 7(1), 8053. doi:10.1038/s41598-017-08695-3

Ministerio de Salud. (20 de julio de 2021). Registro de reporte obligatorio. https://www.ministeriodesalud.go.cr/

Nathan, C. y Ding, A. (2010). Nonresolving Inflammation. Cell, 140(6), 871–882. doi:10.1016/j.cell.2010.02.029

National Institute of Mental Health (NIMH) (20 de julio del 2021). Major Depression. Recuperado de https://www.nimh.nih.gov/health/statistics/major-depression

Organización Mundial de la Salud. (2021). (3 de noviembre del 2021). Gender and women's mental health. Recuperado de https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/gender-and-women-s-mental-health

Organización Mundial de la Salud. (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization.

Organización Mundial de la Salud. (2020). The impact of COVID-19 on mental, neurological and substance use services: results of a rapid assessment. Geneva: World Health Organization.

Ormel, J., Hartman, C. A. y Snieder, H. (2019). The genetics of depression: successful genome-wide association studies introduce new challenges. Translational Psychiatry, 9(1), 114. doi: 10.1038/s41398-019-0450-5

Phillips, C. (2017). Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the Neuroplastic Connection. Neural plasticity, 2017, 7260130. doi: 10.1155/2017/7260130

Popoli, M., Yan, Z., McEwen, B. S. y Sanacora, G. (2011). The stressed synapse: the impact of stress and glucocorticoids on glutamate transmission. Nature Reviews. Neuroscience, 13(1), 22-37. doi: 10.1038/nrn3138

Queen, N. J., Hassan, Q. N. II. y Cao, L. (2020). Improvements to Healthspan Through Environmental Enrichment and Lifestyle Interventions: Where Are We Now?. Frontiers in Neuroscience, 14, 605. doi: 10.3389/fnins.2020.00605

Recio-Barbero, M., & Pérez-Fernandez, I. (2019). Gender Bias in Research: How Does It Affect Mental Health?. In Psychopathology in Women (pp. 865-883). Springer, Cham. doi: 10.1007/978-3-030-15179-9_37

Rojas-Carvajal, M., Sequeira-Cordero, A. y Brenes, J. C. (2021). The environmental enrichment model revisited: A translatable paradigm to study the stress of our modern lifestyle. The European Journal of Neuroscience. doi: 10.1111/ejn.15160

Rosero-Bixby, L., Modrek, S., Domino, M. E. y Dow, W. H. (2015). Aging and Mental Health in a Longitudinal Study of Elderly Costa Ricans. Encyclopedia of Geropsychology. doi: 10.1007/978-981-287-080-3_37-1

Sequeira-Cordero, A., Salas-Bastos, A., Fornaguera, J. y Brenes, J. C. (2019). Behavioural characterisation of chronic unpredictable stress based on ethologically relevant paradigms in rats. Scientific Reports, 9(1), 17403. doi: 10.1038/s41598-019-53624-1

Slavich, G. M. y Irwin, M. R. (2014). From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. Psychological bulletin, 140(3), 774–815. doi: 10.1037/a0035302

Thyfault, J. P. y Bergouignan, A. (2020). Exercise and metabolic health: beyond skeletal muscle. Diabetologia, 63(8), 1464-1474. doi: 10.1007/s00125-020-05177-6

Villas Boas, G. R., Boerngen de Lacerda, R., Paes, M. M., Gubert, P., Almeida, W. L. d. C., Rescia, V. C., … Oesterreich, S. A. (2019). Molecular aspects of depression: A review from neurobiology to treatment. European Journal of Pharmacology, 851, 99-121. doi: 10.1016/j.ejphar.2019.02.024

Wiskott, L., Rasch, M. J. y Kempermann, G. (2006). A functional hypothesis for adult hippocampal neurogenesis: avoidance of catastrophic interference in the dentate gyrus. Hippocampus, 16(3), 329-343. doi: 10.1002/hipo.20167

Wright, L. J., Williams, S. E., & Veldhuijzen van Zanten, J. (2021). Physical Activity Protects Against the Negative Impact of Coronavirus Fear on Adolescent Mental Health and Well-Being During the COVID-19 Pandemic. Frontiers in psychology, 12, 580511. https://doi.org/10.3389/fpsyg.2021.580511

Wurtman, R. J. (1988). Effects of their nutrient precursors on the synthesis and release of serotonin, the catecholamines, and acetylcholine: implications for behavioral disorders. Clinical Neuropharmacology, 11 Suppl 1, S187-S193.

Comentarios

Descargas

Los datos de descargas todavía no están disponibles.