Introduction
The mode of interaction between humans is through touch sensation (either being touched or touching someone). It is widely recognized in traditional medicine and through ancient evidence that the well-being of the body and mind are closely interconnected. Increasingly robust evidence now indicates a correlation between disorders affecting the hypothalamic-pituitary-adrenal axis (HPA) axis and the likelihood of developing psychiatric conditions.
For instance, abnormal or exaggerated responses to stress are integral to the diagnostic criteria of various psychiatric disorders like depression and anxiety disorders. Notably, peripheral conditions such as metabolic disorders and cardiovascular diseases also exhibit associations with HPA alterations. Moreover, numerous systemic disorders linked to a heightened occurrence of psychiatric conditions involve significant inflammatory components.
Inflammatory and endocrine pathways appear to interact both peripherally and within the central nervous system (CNS), exacerbating states of psychiatric dysfunction. This review consolidates clinical and animal research, exploring the interplay between peripheral and central factors and offering insights into how bodily processes at the molecular and cellular levels can influence mental well-being and psychiatric health.
What Is the Link Between Blood Disorders and Mental Health?
Patients with severe mental disorders typically have a significantly reduced life expectancy, ranging from 10 to 25 years less than the general population. This alarming statistic necessitates urgent action from healthcare providers and governments worldwide. The factors contributing to this high mortality rate can be categorized into those concerning the patients themselves, psychiatrists, other medical professionals, and the broader healthcare system.
Among the factors relating to individuals with mental disorders, the presence of concurrent physical illnesses such as cardiovascular, respiratory, metabolic, infectious diseases, and cancer is particularly noteworthy. Unfortunately, these physical health issues often receive inadequate attention in conventional psychiatric practice.
The longstanding segregation of psychiatry from other medical specialties, coupled with the lack of emphasis on physical health by many psychiatrists, contributes to the prevalence of physical comorbidities and their role in mortality among individuals with mental disorders. Moreover, collaboration between psychiatrists and primary care physicians, as well as other healthcare professionals, is frequently lacking, with negative attitudes towards individuals with mental disorders further exacerbating the situation.
International bodies and associations have initiated efforts to address these challenges, including the World Health Organization (WHO), the World Psychiatric Association (WPA), the European Psychiatric Association, the UK Royal College of Psychiatrists, and the UK Royal College of Practitioners. These initiatives include revising educational curricula for healthcare professionals and establishing specialized working groups focused on managing the comorbidity of mental and physical disorders.
The WPA Working Group on Managing Comorbidity of Mental and Physical Disorders, chaired by N. Sartorius, has been tasked with several objectives, including identifying areas for research, education, and service development related to comorbidity, fostering collaboration among stakeholders, organizing symposia and workshops, preparing evidence reviews and position papers, and developing training programs.
To achieve these objectives, the Working Group implements various strategies, such as organizing collaborative events, developing educational resources, supporting capacity-building efforts in low-resource settings, advocating for funding and policy support, collaborating with governmental and non-governmental organizations, and coordinating with other WPA working groups and scientific sections.
What Is the Mechanism Of the Link Between Blood Disorders and Mental Health?
The most established instance of the interaction between mind and body is the correlation between psychological stress and mental health issues. Abnormal or heightened reactions to stressful situations are integral to the diagnostic criteria for various psychiatric conditions, such as depression and anxiety disorders.
The body's reaction to stress is managed by the hypothalamic-pituitary-adrenal (HPA) axis, through which stressful stimuli regulate the activity of a carefully controlled cycle of circulating hormones. Stress itself is not necessarily harmful. The body is adept at responding to stressors, and to some degree, stress is essential for normal functioning. However, excessive or prolonged stress or disruptions in the function or regulation of the HPA axis can lead to abnormal alterations in hormone levels circulating both in the body and the central nervous system (CNS).
As mentioned earlier, women are twice as likely as men to experience stress-related psychiatric disorders, and there is evidence suggesting that disparities in stress responses between sexes could explain this gender imbalance. The HPA axis serves as the primary system that regulates the body's response to stress and controls the levels of glucocorticoid hormones in circulation.
Arginine vasopressin (AVP) and corticotrophin-releasing hormone (CRH, previously known as CRF or corticotrophin-releasing factor) are produced and released from the paraventricular nucleus (PVN) of the hypothalamus and are considered the highest level regulators of HPA axis activity within the central nervous system (CNS). These neuro-hormones work together to stimulate the secretion of adrenocorticotrophin (ACTH) from the anterior pituitary gland, leading to increased levels of circulating cortisol (CORT).
The HPA axis is regulated by a negative feedback loop involving the hippocampus, hypothalamus, and anterior pituitary. Once cortisol is released into the bloodstream, it enters cells, particularly in the pituitary, hypothalamus, and hippocampus, where it binds to glucocorticoid receptors (GR). Finally, the breakdown of glucocorticoids involves enzymes such as 5α-reductase type 1 (mainly found in the liver) and 11β-hydroxysteroid dehydrogenase type 2 (found in the kidney).
Conclusion
In summary, addressing the physical health needs of individuals with severe mental disorders requires comprehensive and coordinated efforts from healthcare providers, policymakers, and international organizations to improve outcomes and reduce premature mortality in this vulnerable population. For a long time, traditional medicine and anecdotal evidence have emphasized the interconnectedness of physical and mental health.
While literature often mentions the correlation between bodily ailments and psychological issues, Western medicine has recently started investigating the underlying mechanisms. Emerging evidence suggests that disruptions to inflammatory and endocrine pathways, both in the body and the central nervous system (CNS), may contribute to conditions like depression.
Specifically, research points to microglia, CNS inflammatory cells, as a critical link between hormonal activity, inflammation, and neuronal dysfunction. This review primarily focuses on how bodily dysfunction can affect neuronal function and mental health. However, it is essential to acknowledge the psychological impact of poor health on mental well-being. The stress associated with chronic illness or suboptimal health can exacerbate psychiatric conditio
