Dipartimento di Medicina Clinica e Sperimentale, University of Pisa, via Roma, 67, I-56100 Pisa, Italy.
Curr Med Chem. 2013;20(23):2861-7. doi: 10.2174/0929867311320230002.
Several population-based studies and clinical data suggest the presence of strict relationships between epilepsy and depression. The incidence of depressive symptoms in patients with epilepsy is significantly higher than in the general population or in patients with other neurological disorders or chronic diseases, as shown by the majority, albeit not all, findings. Even the rate of suicide is higher in epileptic patients than in the general population. Such observations suggest the existence of common neurobiological substrates involving hyperactivity of the hypothalamus-pituitary-adrenal axis, as well as disturbances of different neurotransmitter systems, particularly serotonin and norepinephrine. The aim of this paper is to review the current literature on the prevalence, clinical manifestations and etiology of depression in epilepsy, with a particular focus on the possible pathophysiological mechanisms shared by the two conditions. In spite of the large amount of data, several questions remain open and further studies are necessary to explore more thoroughly the complex and bidirectional relationships between epilepsy and depression.
几项基于人群的研究和临床数据表明，癫痫与抑郁之间存在严格的关系。大多数（并非全部）研究发现，癫痫患者出现抑郁症状的发生率明显高于普通人群或其他神经障碍或慢性疾病患者。甚至癫痫患者的自杀率也高于普通人群。这些观察结果表明，存在涉及下丘脑-垂体-肾上腺轴过度活跃以及不同神经递质系统（特别是 5-羟色胺和去甲肾上腺素）紊乱的共同神经生物学基础。本文旨在回顾目前关于癫痫中抑郁的流行率、临床表现和病因的文献，特别关注这两种疾病共有的可能的病理生理机制。尽管有大量数据，但仍有几个问题悬而未决，需要进一步研究以更深入地探讨癫痫和抑郁之间复杂的双向关系。
