焦虑抑郁发作和排斥敏感性——一种治疗难治性抑郁症的新方法。

IF 2 Q3 NEUROSCIENCES Neuropsychopharmacology Reports Pub Date : 2024-03-01 Epub Date: 2023-12-07 DOI:10.1002/npr2.12399
Hisanobu Kaiya
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引用次数: 0

摘要

本文旨在寻找治疗难治性抑郁症(TRD)解决方案的线索。抑郁与焦虑共病往往是治疗抵抗焦虑抑郁发作(ADA)往往潜伏。ADA是最近提出的一种临床观点,它只是恐慌发作的心理版本。它通常以突然的强烈焦虑开始,随后是不间断的侵入性想法;因强烈的焦虑、激动和孤独而产生的对后悔或忧虑的持续沉思。在发作期间,还可以观察到故意自残和过量用药等行为。排斥敏感性(rejection sensitivity, RS)作为ADA的基本精神病理,通过结构方程模型揭示。据说,RS在抑郁症中的存在意味着预后不良。文献综述了RS的生物学标志物:一是μ-阿片受体功能参与RS,二是内侧前额皮质多巴胺D4受体(DRD4)的超敏反应。后者已在恐惧条件下的动物实验中得到证实。操纵μ-阿片受体功能和DRD4功能可能最终治疗RS,这可能有助于通过改善ADA来治疗TRD。
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Anxious-depressive attack and rejection sensitivity-Toward a new approach to treatment-resistant depression.

This paper aimed to find clues to treatment-resistant depression (TRD) solutions. Depression comorbid with anxiety is often treatment-resistant where anxious-depressive attack (ADA) often lurks. ADA is a recently proposed clinical idea for just a psychological version of a panic attack. It mostly begins with an abrupt surge of intense anxiety followed by uninterrupted intrusive thoughts; lasting ruminations about regret or worry produced by violent anxiety, agitation, and loneliness. Acting-out behaviors such as deliberate self-injury and over-dose may also be observed during the attack. As the basic psychopathology of ADA, rejection sensitivity (RS) was revealed by a structural equation model. It is said that the presence of RS in depressive disorders implies a poor prognosis. The following biological markers for RS were reviewed in the literature: first, the involvement of the μ-opioid receptor function in RS and, secondly, hypersensitivity of the dopamine D4 receptor (DRD4) in the medial prefrontal cortex. The latter has been suggested in fear-conditioned animal experiments. Manipulation of the μ-opioid receptor function together with the DRD4 function may culminate in a treatment for RS, which could contribute to the development of a treatment for TRD via the improvement of ADA.

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来源期刊
Neuropsychopharmacology Reports
Neuropsychopharmacology Reports Psychology-Clinical Psychology
CiteScore
3.60
自引率
4.00%
发文量
75
审稿时长
14 weeks
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