van Praag H M
Department of Psychiatry, Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY.
Eur Neuropsychopharmacol. 1992 Dec;2(4):393-404. doi: 10.1016/0924-977x(92)90001-o.
5-HT disturbances in depression (as exemplified by lowered CSF 5-HIAA) are not syndrome specific but related to components of the depressive syndrome, specifically to increased anxiety and aggression. These 5-HT disturbances are probably core pathogenetic processes not derivative features. I hypothesized that in this subtype of depression, i.e. in "5-HT related depression", the key psychopathological disturbances are dysregulation of anxiety and aggression, while mood lowering is a "by-product". Based on this hypothesis it was predicted that agents which ameliorate anxiety and/or aggression via harmonization of 5-HT ergic transmission will, in addition, exert overall antidepressant effect in "5-HT related depression". The study of the relative "weight" of the various psychopathological components of depression is a basic exercise in understanding the nature of that condition and could, as such, greatly facilitate the goal-directed search for new and innovative antidepressants.
抑郁症中的5-羟色胺紊乱（如脑脊液中5-羟吲哚乙酸降低所示）并非综合征特异性的，而是与抑郁综合征的组成部分相关，特别是与焦虑和攻击性增加有关。这些5-羟色胺紊乱可能是核心致病过程，而非衍生特征。我假设在这种抑郁症亚型中，即“与5-羟色胺相关的抑郁症”中，关键的精神病理紊乱是焦虑和攻击性的调节失调，而情绪低落是一种“副产品”。基于这一假设，预计通过协调5-羟色胺能传递来改善焦虑和/或攻击性的药物，此外，将在“与5-羟色胺相关的抑郁症”中发挥全面的抗抑郁作用。对抑郁症各种精神病理成分的相对“权重”进行研究，是理解该病症本质的一项基本工作，因此，可以极大地促进有针对性地寻找新型创新抗抑郁药物的目标。
