Rao Uma, Chen Li-Ann
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX 75390-9101, USA.
Curr Drug Abuse Rev. 2008 Jan;1(1):68-80. doi: 10.2174/1874473710801010068.
Adolescents are at heightened risk for the development of both depressive and substance-related disorders. These two disorders frequently co-occur in adolescents and are associated with significant morbidity and mortality. Given the substantial economic and psychosocial burden associated with the comorbid condition, the identification of causal mechanisms associated with their co-occurrence is of great public health importance. Although there is significant understanding of the environmental and neurobiological factors involved in depression and addictive disorders considered separately, the mechanisms underlying the comorbid illness have not been investigated carefully. The purpose of this review is to summarize the extant literature on genetic, environmental and neurobiological processes involved in the etiology of depressive and substance-related disorders in adolescents and adults. It is important to note that the data on common neurobiological systems that link addictive and depressive disorders are primarily from research with adult animals and humans. Given the ongoing maturation of these systems throughout adolescence and early adult life, it is not clear how these neurobiological processes influence the development and progression of both disorders. A better understanding of the pathophysiological mechanisms leading to the onset and course of these disorders during adolescence will be helpful in developing more effective preventive and treatment strategies not only for this population but also for adult patients with early-onset illness.
青少年患抑郁症和物质相关障碍的风险更高。这两种障碍在青少年中经常同时出现，并与显著的发病率和死亡率相关。鉴于共病状况带来的巨大经济和心理社会负担，确定与其共病相关的因果机制具有重大的公共卫生意义。尽管对于分别考虑的抑郁症和成瘾性障碍所涉及的环境和神经生物学因素已有大量了解，但共病疾病的潜在机制尚未得到仔细研究。本综述的目的是总结关于青少年和成年人抑郁症及物质相关障碍病因中涉及的遗传、环境和神经生物学过程的现有文献。需要注意的是，将成瘾性和抑郁症联系起来的常见神经生物学系统的数据主要来自对成年动物和人类的研究。鉴于这些系统在整个青春期和成年早期都在持续成熟，尚不清楚这些神经生物学过程如何影响这两种障碍的发展和进程。更好地理解导致青春期这些障碍的发病和病程的病理生理机制，不仅有助于为这一人群制定更有效的预防和治疗策略，也有助于为早发性疾病的成年患者制定相关策略。
