Depressive Disorder, Major

抑郁障碍,Major
  • 文章类型: Journal Article
    DSM-III重度抑郁症(MD)的症状标准源自于1972年由Faighner及其同事提出的标准,与1957年由Cassidy发表的标准非常相似。我在这里介绍了一个反事实的历史,其中费斯纳仔细阅读了卡西迪的关键参考资料,1953年,坎贝尔对抑郁症患者进行了一项大型随访研究,并提供了详细的抑郁体征和症状表。在这个替代时间线中,坎贝尔的结果修改了医学博士的Faighner标准,然后改变了DSM-III和随后的MD标准集。当前DSMMD标准的历史路径取决于一系列历史事件,并且很容易有所不同。这个故事并不是要批评表现良好的DSMMD标准。相反,这表明这些标准代表了一组有用但容易出错的症状/体征,这些症状/体征指数不构成MD,因此不应加以证实.
    UNASSIGNED: The DSM-III symptomatic criteria for major depression (MD) were derived from those proposed by Feighner and colleagues in 1972, which closely resembled those published by Cassidy in 1957. I here present a counter-factual history in which Feighner carefully read a key reference in Cassidy, a large 1953 follow-up study by Campbell of depressed patients with detailed tables of depressive signs and symptoms. In this alternative timeline, the Feighner criteria for MD were modified by Campbell\'s results, which then changed DSM-III and subsequent MD criteria sets. The historical pathway to the current DSM MD criteria was contingent on a range of historical events and could easily have been different. This story is not meant to criticize DSM MD criteria that perform well. Rather, it suggests that these criteria represent a useful but fallible set of symptoms/signs that index but do not constitute MD and therefore are not to be reified.
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  • 文章类型: Journal Article
    基本原理:最近的证据强调了线粒体功能障碍在情绪障碍中的关键作用,但其机制尚不清楚.我们研究了Hippo/YAP/14-3-3η信号通路是否介导线粒体异常,从而导致小鼠模型中重度抑郁症(MDD)的发作。方法:ROC算法用于鉴定暴露于慢性不可预测的轻度应激(CUMS)并表现出最突出的抑郁表型(Dep)的小鼠亚群。电子显微镜,生化化验,定量PCR,免疫印迹用于评估基底外侧杏仁核(BLA)的突触和线粒体变化。RNA测序用于探索Hippo途径和下游靶基因的变化。使用体外药理学抑制和免疫沉淀来确认YAP/14-3-3η相互作用及其在神经元线粒体功能障碍中的作用。我们在YAP转基因小鼠中使用病毒介导的基因过表达和敲除来验证Hippo/YAP/14-3-3η途径对抑郁样行为的调节作用。结果:转录组数据鉴定了大量基因和信号通路,这些基因和信号通路从Dep小鼠的BLA中特异性改变。Dep小鼠在BLA神经元中表现出明显的突触损伤,以及以线粒体形态异常为特征的线粒体损伤,功能受损,受损的生物发生,和线粒体标记蛋白的改变。在CUMS期间,Dep小鼠的Hippo信号通路被激活,YAP的转录调节活性被其Ser127位点的磷酸化抑制。14-3-3η被确定为Hippo/YAP途径的重要共调节因子,因为它可以响应慢性应激并调节YAP的细胞质保留。重要的是,整合的Hippo/YAP/14-3-3η途径介导了Dep小鼠的神经元线粒体功能障碍和抑郁行为。结论:BLA神经元中整合的Hippo/YAP/14-3-3η通路在介导小鼠抑郁样行为中起着至关重要的作用。提示该途径在慢性应激诱导的抑郁症易感性中的因果作用。因此,该途径可能是针对MDD中线粒体功能障碍和突触损伤的治疗靶标。
    Rationale: Recent evidence highlights the pivotal role of mitochondrial dysfunction in mood disorders, but the mechanism involved remains unclear. We studied whether the Hippo/YAP/14-3-3η signaling pathway mediates mitochondrial abnormalities that result in the onset of major depressive disorder (MDD) in a mouse model. Methods: The ROC algorithm was used to identify a subpopulation of mice that were exposed to chronic unpredictable mild stress (CUMS) and exhibited the most prominent depressive phenotype (Dep). Electron microscopy, biochemical assays, quantitative PCR, and immunoblotting were used to evaluate synaptic and mitochondrial changes in the basolateral amygdala (BLA). RNA sequencing was used to explore changes in the Hippo pathway and downstream target genes. In vitro pharmacological inhibition and immunoprecipitation was used to confirm YAP/14-3-3η interaction and its role in neuronal mitochondrial dysfunction. We used virus-mediated gene overexpression and knockout in YAP transgenic mice to verify the regulatory effect of the Hippo/YAP/14-3-3η pathway on depressive-like behavior. Results: Transcriptomic data identified a large number of genes and signaling pathways that were specifically altered from the BLA of Dep mice. Dep mice showed notable synaptic impairment in BLA neurons, as well as mitochondrial damage characterized by abnormal mitochondrial morphology, compromised function, impaired biogenesis, and alterations in mitochondrial marker proteins. The Hippo signaling pathway was activated in Dep mice during CUMS, and the transcriptional regulatory activity of YAP was suppressed by phosphorylation of its Ser127 site. 14-3-3η was identified as an important co-regulatory factor of the Hippo/YAP pathway, as it can respond to chronic stress and regulate cytoplasmic retention of YAP. Importantly, the integrated Hippo/YAP/14-3-3η pathway mediated neuronal mitochondrial dysfunction and depressive behavior in Dep mice. Conclusion: The integrated Hippo/YAP/14-3-3η pathway in the BLA neuron is critical in mediating depressive-like behaviors in mice, suggesting a causal role for this pathway in susceptibility to chronic stress-induced depression. This pathway therefore may present a therapeutic target against mitochondrial dysfunction and synaptic impairment in MDD.
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  • 文章类型: English Abstract
    目的:通过全基因组关联研究确定与抑郁症和海马(HIP)相关的其他基因座。
    方法:抑郁症相关的全基因组关联研究(GWAS)元摘要数据从精神病学基因组学联盟的官方网站下载,涉及170756例病例和329443例对照。从英国生物库下载左右海马体GWAS数据集,其中涉及33224名参与者。条件性错误发现率(condFDR)用于识别抑郁症和左右海马体积的新遗传基因座,结合错误发现率(conjFDR)用于评估抑郁症与左右海马体积之间多效性位点的富集。
    结果:分别,7、13和12个新基因座与抑郁症有关,左海马体积和右海马体积,condFDR的显著阈值<0.01。发现一个rs1267073位点与抑郁症和右海马体积共有,阈值为conjFDR<0.01。
    结论:以上发现为海马体积和抑郁症风险的遗传机制提供了更多的见解。结果也可能为未来治疗抑郁症的临床试验提供证据。
    OBJECTIVE: To identify additional loci associated with depression and the hippocampus (HIP) through genome-wide association study.
    METHODS: The depression-related genome-wide association study (GWAS) meta summary data was downloaded from the official website of the Psychiatric Genomics Consortium, which had involved 170 756 cases and 329 443 controls. The left and right hippocampal volume GWAS data sets were downloaded from the UK Biobank, which involved 33 224 participants. The conditional false discovery rate (condFDR) was used to identify novel genetic loci for depression and left and right hippocampal volumes, and a conjunctional false discovery rate (conjFDR) was used to evaluate the enrichment of pleiotropic loci between depression and left and right hippocampal volumes.
    RESULTS: Respectively, 7, 13, and 12 new loci have been associated with depression, left hippocampal volume and right hippocampal volume, with a significant threshold of condFDR < 0.01. A site of rs1267073 locus was found to be shared by the depression and right hippocampal volume with a threshold of conjFDR < 0.01.
    CONCLUSIONS: Above findings have provided more insights into the genetic mechanisms underlying the volume of hippocampus and the risk for depression. The results may also provide evidence for future clinical trials for treating depression.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    重度抑郁症(MDD)是一种精神疾病,影响全球超过3亿人,对社会产生严重影响。已知基于单胺假说的靶向脑中单胺的常规抗抑郁药在30%的MDD患者中需要延长的时间才能有效或较不有效。因此,有必要开发抗抑郁剂,这些抗抑郁剂可有效对抗难治性抑郁症,并具有不同于单胺假说的新机制.包括我们在内的越来越多的研究小组已经建立了垂体腺苷酸环化酶激活多肽(PACAP)及其受体之一,PAC1受体,与应激相关疾病如MDD的病因密切相关。因此,强烈建议PAC1受体是治疗精神疾病的有希望的靶标。我们开发了一部小说,非肽,小分子,高亲和力PAC1受体拮抗剂,并在小鼠中进行行为药理学实验,以表征新型PAC1受体拮抗剂作为MDD治疗的新选择。结果表明,我们的新型PAC1受体拮抗剂具有成为具有高安全性的新型抗抑郁药的潜力。在这次审查中,我们想介绍开发新型PAC1受体拮抗剂的背景及其对急性应激小鼠模型的影响。
    Major depressive disorder (MDD) is a psychiatric disorder that affects more than 300 million people worldwide and has a serious impact on society. Conventional antidepressants targeting monoamines in the brain based on the monoamine hypothesis are known to take a prolonged time to be effective or less effective in 30% of MDD patients. Hence, there is a need to develop antidepressants that are effective against treatment-resistant depression and have a new mechanism different from the monoamine hypothesis. An increasing number of research groups including us have been establishing that pituitary adenylate cyclase-activating polypeptide (PACAP) and one of its receptors, PAC1 receptor, are closely related to the etiology of stress-related diseases such as MDD. Therefore, it is strongly suggested that the PAC1 receptor is a promising target in the treatment of psychiatric disorders. We developed a novel, non-peptidic, small-molecule, high-affinity PAC1 receptor antagonists and conducted behavioral pharmacology experiments in mice to characterize a novel PAC1 receptor antagonist as a new option for MDD therapy. The results show that our novel PAC1 receptor antagonist has the potential to be a new antidepressant with a high safety profile. In this review, we would like to present the background of developing our novel PAC1 receptor antagonist and its effects on mouse models of acute stress.
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  • 文章类型: Journal Article
    重度抑郁症(MDD)构成了巨大的全球健康负担,30-40%的患者对标准临床抗抑郁药产生耐药性,如选择性5-羟色胺再摄取抑制剂和三环抗抑郁药。2016年,Carhart-Harris和他的同事报告说,psilocybin,来自神奇蘑菇的致幻化合物,在难治性抑郁症患者中表现出快速和持久的抗抑郁作用。随后的临床研究发现了psilocybin在MDD中的治疗潜力,双相情感障碍的抑郁发作,厌食症,和毒瘾。在2018年和2019年,美国食品和药物管理局将psilocybin指定为治疗难治性抑郁症和MDD的“突破性药物”,分别。值得注意的是,psilocybin的副作用仅限于短暂和轻微的问题,如头痛和疲劳,表明它的安全性。在2023年,我们发表了关于5-羟色胺5-HT2A受体在5-羟色胺能迷幻药的抗抑郁作用中的作用的评论(NihonYakuriakuZasshi,第158卷,第3期,第229-232页)。这里,我们介绍了我们的研究以及关于psilocybin抗抑郁作用的最新临床和临床前研究,并概述了与psilocybin治疗相关的潜力和问题。
    Major Depressive Disorder (MDD) poses a significant global health burden, with 30-40% patients developing resistance to standard clinical antidepressants, such as selective serotonin reuptake inhibitors and tricyclic antidepressants. In 2016, Carhart-Harris and colleagues reported that psilocybin, the hallucinogenic compound derived from magic mushrooms, exhibits rapid and enduring antidepressant effects in patients with treatment-resistant depression. Subsequent clinical studies have found the therapeutic potential of psilocybin in MDD, depressive episode in bipolar disorder, anorexia, and drug addiction. In 2018 and 2019, the U.S. Food and Drug Administration designated psilocybin as a \"breakthrough medicine\" for treatment-resistant depression and MDD, respectively. Notably, the side effects of psilocybin are limited to transient and mild issues, such as headache and fatigue, suggesting its safety. In 2023, we published a review on the role of serotonin 5-HT2A receptors in the antidepressant effects of serotonergic psychedelics (Nihon Yakurigaku Zasshi, Volume 158, Issue 3, Page 229-232). Here, we present our study alongside the latest clinical and preclinical research on the antidepressant effects of psilocybin and provide an overview of the potential and issues related to psilocybin therapy.
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  • 文章类型: Journal Article
    观察性研究报告了多种常见皮肤病与精神疾病之间的关系。评估3种皮肤病(牛皮癣,湿疹,和荨麻疹)和4种精神疾病(双相情感障碍,精神分裂症,重度抑郁症,和焦虑)在欧洲人口中,我们使用孟德尔随机化(MR)分析,这为因果推断提供了明确的证据。使用全基因组关联研究数据库筛选皮肤病和精神疾病的合格单核苷酸多态性。我们进行了双向,使用与银屑病相关的工具变量进行2样本MR分析,湿疹,和荨麻疹作为暴露因素,和双相情感障碍,精神分裂症,严重的抑郁症,和焦虑作为结果。双相情感障碍的反向MR分析,精神分裂症,严重的抑郁症,焦虑和牛皮癣,湿疹,和荨麻疹作为结果也进行了,并使用方差反加权(IVW)分析因果关系,MR-Egger,和加权中位数方法。为了彻底评估因果关系,使用IVW进行敏感性分析,MR-PRESSO,和MR-Egger方法。结果显示,双相情感障碍增加了银屑病的发病率(比值比=1.271,95%置信区间=1.003-1.612,P=.047),在IVW中使用CochranQ检验进行的异质性检验显示P值>.05,(P=.302),多重检验中的MR-Pleiotropy和MR-PRESSO(异常值方法)显示P值>.05,(P=.694;P=.441),和MR-Pleiotropy证据显示没有明显的截距(截距=-0.060;SE=0.139;P=.694)。重度抑郁症增加了患湿疹的风险(比值比=1.002,95%置信区间=1.000-1.004,P=.024),异质性检验显示P值>.05,(P=.328),多重性检测显示P值>.05,(P=.572;P=.340),和MR-Pleiotropy证据显示没有明显的截距(截距=-0.099;SE=0.162;P=.572)。上述结果的敏感性分析是可靠的,没有发现异质性或多重性。这项研究表明,双相情感障碍和牛皮癣之间存在统计学上显著的因果关系,严重的抑郁症,和欧洲人口的湿疹,这可以为医生在常见皮肤疾病的临床管理提供重要信息。
    Observational studies have reported a relationship between multiple common dermatoses and mental illness. To assess the potential bidirectional causality between 3 skin disorders (psoriasis, eczema, and urticaria) and 4 psychiatric disorders (bipolar disorder, schizophrenia, major depressive disorder, and anxiety) in the European population, we used Mendelian randomization (MR) analysis, which provides definitive evidence for causal inference. Eligible single nucleotide polymorphisms were screened for dermatological and psychiatric disorders using a genome-wide association study database. We conducted bidirectional, 2-sample MR analysis using instrumental variables related to psoriasis, eczema, and urticaria as exposure factors, and bipolar disorder, schizophrenia, major depression, and anxiety as outcomes. Reverse MR analysis with bipolar disorder, schizophrenia, major depression, and anxiety as exposure and psoriasis, eczema, and urticaria as outcomes were also performed, and the causality was analyzed using inverse-variance weighting (IVW), MR-Egger, and weighted median methods. To thoroughly assess causality, sensitivity analyses were conducted using the IVW, MR-PRESSO, and MR-Egger methods. The results showed that bipolar disorder increased the incidence of psoriasis (odds ratio = 1.271, 95% confidence interval = 1.003-1.612, P = .047), heterogeneity test with Cochran Q test in the IVW showed P value > .05, (P = .302), the MR-Pleiotropy and MR-PRESSO (outlier methods) in the multiplicity test showed P value > .05, (P = .694; P = .441), and MR-Pleiotropy evidence showed no apparent intercept (intercept = -0.060; SE = 0.139; P = .694). Major depression increased the risk of eczema (odds ratio = 1.002, 95% confidence interval = 1.000-1.004, P = .024), heterogeneity test showed P value > .05, (P = .328), multiplicity detection showed P value > .05, (P = .572; P = .340), and MR-Pleiotropy evidence showed no apparent intercept (intercept = -0.099; SE = 0.162; P = .572). Sensitivity analyses of the above results were reliable, and no heterogeneity or multiplicity was found. This study demonstrated a statistically significant causality between bipolar disorder and psoriasis, major depression, and eczema in a European population, which could provide important information for physicians in the clinical management of common skin conditions.
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  • 文章类型: Journal Article
    心率变异性(HRV)与心脏迷走神经控制和情绪调节有关,是心脏迷走神经控制和心脏自主神经活动的指标。这项研究旨在开发台湾HRV规范数据库,涵盖20至70岁的个人,并评估其在重度抑郁症(MDD)患者中的诊断有效性。共有311名健康参与者在HRV规范数据库中,并分为五组10岁年龄组,然后计算HRV指数的均值和标准差。我们招募了272名MDD患者进行交叉验证,将他们的HRV指数与规范数据库进行了比较,然后将其转换为Z评分,以探讨MDD患者与健康组的HRV偏差。结果发现,随着年龄的增长,HC组的HRV指数逐渐下降,HC组中的女性比男性表现出更高的心脏迷走神经控制和副交感神经活动。相反,MDD组患者的HRV指数低于HC组,他们的抑郁和焦虑症状与HRV指数呈负相关。台湾HRV规范数据库具有良好的心理计量特征的交叉验证。
    Heart rate variability (HRV) is related to cardiac vagal control and emotional regulation and an index for cardiac vagal control and cardiac autonomic activity. This study aimed to develop the Taiwan HRV normative database covering individuals aged 20 to 70 years and to assess its diagnosing validity in patients with major depressive disorder (MDD). A total of 311 healthy participants were in the HRV normative database and divided into five groups in 10-year age groups, and then the means and standard deviations of the HRV indices were calculated. We recruited 272 patients with MDD for cross-validation, compared their HRV indices with the normative database, and then converted them to Z-scores to explore the deviation of HRV in MDD patients from healthy groups. The results found a gradual decline in HRV indices with advancing age in the HC group, and females in the HC group exhibit higher cardiac vagal control and parasympathetic activity than males. Conversely, patients in the MDD group demonstrate lower HRV indices than those in the HC group, with their symptoms of depression and anxiety showing a negative correlation with HRV indices. The Taiwan HRV normative database has good psychometric characteristics of cross-validation.
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  • 文章类型: Journal Article
    在患有抑郁症和其他精神疾病的患者中一直观察到星形胶质细胞功能障碍。尽管多年来我们对这些变化的理解,他们的起源,它们对行为和神经元功能的影响加深了,星形胶质细胞功能障碍在重度抑郁症(MDD)和创伤后应激障碍(PTSD)中的许多方面的作用仍然未知.在这次审查中,我们总结了已知的与MDD和PTSD相关的星形胶质细胞功能障碍,强调慢性应激对特定星形胶质细胞功能的影响,以及星形胶质细胞功能障碍如何与抑郁和焦虑样行为的表达有关,关注星形胶质细胞操纵对情绪相关和恐惧学习行为的行为后果。我们还提供了潜在的星形胶质细胞功能,这些功能可以作为潜在的抗抑郁治疗的目标。
    Astrocyte dysfunctions have been consistently observed in patients affected with depression and other psychiatric illnesses. Although over the years our understanding of these changes, their origin, and their consequences on behavior and neuronal function has deepened, many aspects of the role of astroglial dysfunction in major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) remain unknown. In this review, we summarize the known astroglial dysfunctions associated with MDD and PTSD, highlight the impact of chronic stress on specific astroglial functions, and how astroglial dysfunctions are implicated in the expression of depressive- and anxiety-like behaviors, focusing on behavioral consequences of astroglial manipulation on emotion-related and fear-learning behaviors. We also offer a glance at potential astroglial functions that can be targeted for potential antidepressant treatment.
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  • 文章类型: Journal Article
    重度抑郁症(MDD)和物质使用障碍(SUD)通常会导致过早衰老,认知衰退和其他形式的痴呆症的脆弱性增加。这项研究利用先进的系统生物信息学来识别MDD和SUD中的衰老“特征”,并评估了已知的延长寿命的药物靶向和逆转这些特征的潜力。结果表明,抑制FOS基因家族成员的转录激活有望减轻MDD和SUD的过早衰老。相反,抗抑郁药激活PI3K/Akt/mTOR通路,速效抗抑郁药的常见机制,可能会加速MDD患者的衰老,使它们不适合患有痴呆症和阿尔茨海默病等与衰老相关疾病的人。此外,这种创新的方法确定了MDD患者潜在的抗衰老干预措施,比如去铁胺,白藜芦醇,戊酸雌二醇,以及醋酸锌等天然化合物,Genistein,和抗坏血酸,不管共病焦虑症。这些发现阐明了MDD和SUD的过早衰老效应,并为患有与衰老相关疾病的患者提供了治疗策略的见解。包括痴呆症和阿尔茨海默病。
    Major depressive disorder (MDD) and substance-use disorders (SUDs) often lead to premature aging, increasing vulnerability to cognitive decline and other forms of dementia. This study utilized advanced systems bioinformatics to identify aging \"signatures\" in MDD and SUDs and evaluated the potential for known lifespan-extending drugs to target and reverse these signatures. The results suggest that inhibiting the transcriptional activation of FOS gene family members holds promise in mitigating premature aging in MDD and SUDs. Conversely, antidepressant drugs activating the PI3K/Akt/mTOR pathway, a common mechanism in rapid-acting antidepressants, may accelerate aging in MDD patients, making them unsuitable for those with comorbid aging-related conditions like dementia and Alzheimer\'s disease. Additionally, this innovative approach identifies potential anti-aging interventions for MDD patients, such as Deferoxamine, Resveratrol, Estradiol valerate, and natural compounds like zinc acetate, genistein, and ascorbic acid, regardless of comorbid anxiety disorders. These findings illuminate the premature aging effects of MDD and SUDs and offer insights into treatment strategies for patients with comorbid aging-related conditions, including dementia and Alzheimer\'s disease.
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