López-Ibor J J
Psychiatric Service, Hospital Clínico, Complutense University, Madrid, Spain.
Int Clin Psychopharmacol. 1992 Oct;7 Suppl 2:5-11. doi: 10.1097/00004850-199210002-00003.
One of the ongoing problems in biological psychiatry lies in relating clinical laboratory findings to specific symptoms or behaviour patterns. In recent years it has become clear that serotonin (5-HT) is involved in a wide range of psychiatric disorders and in quite specific behaviour patterns, mainly characterized by a poor control of impulses. Psychopharmacotherapy with substances able to enhance the metabolism of serotonin (mainly antidepressants) is able to clinically improve what appear to be very dissimilar conditions. Moreover, antidepressants with serotonergic activity are the only class of drugs able to relieve the symptoms of obsessive compulsive disorder (OCD), which are characterized by a high control of impulses or, more precisely, by a dysfunctional, non-adaptive control of impulses. Recent neurochemical data suggest that a hypersensitivity to 5-HT exists in this condition. Therefore, the hypothesis that serotonin is important for efficient control of impulses is a key to the interpretation of many laboratory findings and to the penetration of the complex field of biological substrates of psychopathology.
生物精神病学中一个长期存在的问题在于将临床实验室检查结果与特定症状或行为模式联系起来。近年来,已经明确血清素(5-羟色胺,5-HT)涉及广泛的精神疾病以及相当特定的行为模式,主要特征是冲动控制不佳。使用能够增强血清素代谢的物质(主要是抗抑郁药)进行心理药物治疗,能够在临床上改善看似非常不同的病症。此外,具有血清素能活性的抗抑郁药是唯一一类能够缓解强迫症(OCD)症状的药物,强迫症的特征是对冲动有高度控制,或者更确切地说,是对冲动的功能失调、非适应性控制。最近的神经化学数据表明,在这种情况下存在对5-HT的超敏反应。因此,血清素对有效控制冲动很重要这一假设,是解释许多实验室检查结果以及深入理解精神病理学复杂生物基础领域的关键。