Clinic of Affective Disorders and General Psychiatry, University Hospital of Psychiatry, Zurich, Switzerland.
World J Biol Psychiatry. 2012 Dec;13(8):556-68. doi: 10.3109/15622975.2012.665477. Epub 2012 Jun 7.
To summarize current concepts on neuroendocrine and genetic principles underlying stress-related depression and to discuss the challenges of personalized treatment in depression.
Review of the literature pertaining to genetic and neuroendocrine basis of stress-related depression including aspects of treatment response with a focus on the hypothalamus-pituitary-adrenal (HPA) axis.
There is increasing evidence that genetic polymorphisms and dysregulation of the HPA axis are associated with the pathophysiology of stress-related depression. Individual stress hormone reactivity seems to be determined by a combination of genetic and environmental factors, contributing to both, resilience or vulnerability.
Although substantial progress has been made, current knowledge is still limited. Further basic and clinical research is needed to identify specific subgroups and to minimize heterogeneity of the depression phenotype. A better characterization is essential to detect genetic and functional predictors of antidepressant treatment response to follow the vision of personalized therapy in psychiatry.
总结应激相关抑郁症的神经内分泌和遗传原则的现有概念，并讨论抑郁症个体化治疗的挑战。
回顾与应激相关抑郁症的遗传和神经内分泌基础相关的文献，包括治疗反应的各个方面，重点是下丘脑-垂体-肾上腺（HPA）轴。
越来越多的证据表明，遗传多态性和 HPA 轴失调与应激相关抑郁症的病理生理学有关。个体应激激素反应似乎由遗传和环境因素共同决定，既有韧性又有脆弱性。
尽管已经取得了重大进展，但目前的知识仍然有限。需要进一步的基础和临床研究来确定特定的亚组，并最大限度地减少抑郁症表型的异质性。更好地描述是必不可少的，以检测抗抑郁治疗反应的遗传和功能预测因子，以实现精神病学个体化治疗的愿景。
