Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina 27599. USA.
Depress Anxiety. 2011 Jun;28(6):E1-E15. doi: 10.1002/da.20833.
It is increasingly axiomatic that depression has widespread adverse physiological effects and, conversely, that a variety of physiological systems impact the risk for developing depression. This convergence of depression and altered physiology is particularly dramatic during midlife--a time during which reproductive failure presages dramatic increases in prevalence of both heart disease and depression. The potentially meaningful and illuminating links between estrogen deficiency, cardiovascular disease (CVD), and depression have largely been obscured, first by assertions, subsequently repudiated, that the perimenopause was not a time of increased risk of depression, and more recently by the denegration of hormone replacement therapy by initial reports of the Women's Health Initiative. Increasingly, however, research has led to unavoidable conclusions that CVD and depression share common, mediating pathogenic processes and that these same processes are dramatically altered by the presence or absence of estrogen (E2). This review summarizes data supporting these contentions with the intent of placing depression and estrogen therapy in their proper physiologic context.
越来越多的事实表明，抑郁会对生理产生广泛的不良影响，反之，各种生理系统也会影响患抑郁的风险。这种抑郁和生理改变的趋同在中年时期尤为明显——在这一时期，生殖功能衰竭预示着心脏病和抑郁症的患病率都将大幅上升。雌激素缺乏、心血管疾病 (CVD) 和抑郁症之间可能具有重要意义和启发性的联系在很大程度上被掩盖了，首先是断言，随后又被否认，即更年期并不是抑郁风险增加的时期，最近又被妇女健康倡议的初步报告贬低了激素替代疗法。然而，越来越多的研究得出了不可避免的结论，即 CVD 和抑郁症有共同的、中介的致病过程，而这些相同的过程会因雌激素 (E2) 的存在或缺失而发生显著改变。本综述总结了支持这些观点的数据，旨在将抑郁和雌激素治疗置于适当的生理环境中。
