Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Addiction. 2010 Oct;105(10):1698-706. doi: 10.1111/j.1360-0443.2009.02890.x.
Both depression and substance use disorders represent major global public health concerns and are often co-occurring. Although there are ongoing discoveries regarding the pathophysiology and treatment of each condition, common mechanisms and effective treatments for co-occurring depression and substance abuse remain elusive. Mindfulness training has been shown recently to benefit both depression and substance use disorders, suggesting that this approach may target common behavioral and neurobiological processes. However, it remains unclear whether these pathways constitute specific shared neurobiological mechanisms or more extensive components universal to the broader human experience of psychological distress or suffering.We offer a theoretical, clinical and neurobiological perspective of the overlaps between these disorders, highlight common neural pathways that play a role in depression and substance use disorders and discuss how these commonalities may frame our conceptualization and treatment of co-occurring disorders. Finally, we discuss how advances in our understanding of potential mechanisms of mindfulness training may offer not only unique effects on depression and substance use, but also offer promise for treatment of co-occurring disorders.
抑郁症和物质使用障碍均是全球性的重大公共卫生关注点，且常共病存在。尽管目前对于每种疾病的病理生理学和治疗方法都在不断探索，但针对共病的抑郁症和物质滥用，其共同的发病机制和有效的治疗方法仍难以捉摸。最近的研究表明，正念训练有益于抑郁症和物质使用障碍，这表明该方法可能针对共同的行为和神经生物学过程。然而，目前尚不清楚这些途径是否构成特定的共同神经生物学机制，或者是否更广泛地构成了人类更普遍的心理困扰或痛苦的体验。我们从理论、临床和神经生物学的角度探讨了这些疾病之间的重叠，强调了在抑郁症和物质使用障碍中起作用的共同神经通路，并讨论了这些共性如何影响我们对共病的概念化和治疗。最后，我们讨论了对正念训练潜在机制的理解进展如何不仅可能对抑郁症和物质使用产生独特的影响，而且为共病的治疗提供了希望。
