Gutman David A, Nemeroff Charles B
Laboratory of Neuropsychopharmacology, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1639 Pierce Drive, Suite 4000 WMRB, Atlanta, GA 30322, USA.
Physiol Behav. 2003 Aug;79(3):471-8. doi: 10.1016/s0031-9384(03)00166-5.
In the search for the underlying biological causes of psychiatric disorders, primary roles for both genetics and environment have been clearly established. A family history of mood or anxiety disorders, representing the genetic component, clearly increases the risk for developing these illnesses in adulthood. The pivotal role of early environmental influences in the pathogenesis of these disorders is also supported by an abundance of both clinical and preclinical data. This review will highlight some of the preclinical and clinical literature that suggests early adverse experience may sensitize corticotropin-releasing factor (CRF) circuitry. The neurobiology of depression highlighting the pathophysiological role of CRF is reviewed. Next, some of the preclinical models of early life stress are discussed; along with a review of the relevant clinical literature that suggests that the functional dysregulation of CRF circuitry in response to early life trauma may contribute to adulthood depression. The discussion will be framed in regards to a stress-diathesis model in which early adverse events result in a sensitized stress axis that predisposes individuals to develop mood disorders.
在探寻精神疾病潜在生物学病因的过程中,遗传学和环境因素的主要作用已得到明确证实。情绪或焦虑障碍的家族病史代表了遗传因素,它显著增加了成年后患这些疾病的风险。早期环境影响在这些疾病发病机制中的关键作用也得到了大量临床和临床前数据的支持。本综述将重点介绍一些临床前和临床文献,这些文献表明早期不良经历可能会使促肾上腺皮质激素释放因子(CRF)神经回路敏感化。本文回顾了强调CRF病理生理作用的抑郁症神经生物学。接下来,将讨论一些早期生活应激的临床前模型;同时回顾相关临床文献,这些文献表明CRF神经回路对早期生活创伤的功能失调可能导致成年期抑郁症。讨论将围绕应激-素质模型展开,在该模型中,早期不良事件会导致应激轴敏感化,使个体易患情绪障碍。