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from
Part 3
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Biological and behavioural processes
By
Robert Dantzer, Integrative Neurobiology, Université Victor Segalen Bordeaux 2, Bordeaux, France,
Nathalie Castanon, Integrative Neurobiology, Université Victor Segalen Bordeaux 2, Bordeaux, France,
Jacques Lestage, Integrative Neurobiology, Université Victor Segalen Bordeaux 2, Bordeaux, France,
Maite Moreau, Integrative Neurobiology, Université Victor Segalen Bordeaux 2, Bordeaux, France,
Lucile Capuron, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
The prevalence of depression in medically ill patients is high, ranging from 5% to 20% versus 3-5% in the general population. This chapter provides an alternative perspective on the intricate relationships that exist between depressive disorders and a large number of chronic medical pathologies. It proposes that alterations in mood occurring in somatic patients reflect the neural consequences of the molecular and cellular events that play a pivotal role in the evolution of the disease. Pro-inflammatory cytokines produced by peripheral innate immune cells play a key role in the development of the local and systemic inflammatory responses. The chapter highlights that when the innate immune system is activated, the brain forms a molecular and cellular image of the peripheral inflammatory response. In motivational terms, fear competes with sickness and, in behavioural terms, fear motivated behaviour takes precedence over sickness behaviour.
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