School of Psychology, Murdoch University, Perth, Western Australia 6150, Australia.
Prog Neuropsychopharmacol Biol Psychiatry. 2013 Aug 1;45:92-9. doi: 10.1016/j.pnpbp.2013.05.005. Epub 2013 May 14.
Rates of obesity are higher than normal across a range of psychiatric disorders, including major depressive disorder, bipolar disorder, schizophrenia and anxiety disorders. While the problem of obesity is generally acknowledged in mental health research and treatment, an understanding of their bi-directional relationship is still developing. In this review the association between obesity and psychiatric disorders is summarised, with a specific emphasis on similarities in their disturbed biological pathways; namely neurotransmitter imbalances, hypothalamus-pituitary-adrenal axis disturbances, dysregulated inflammatory pathways, increased oxidative and nitrosative stress, mitochondrial disturbances, and neuroprogression. The applicability and effectiveness of weight-loss interventions in psychiatric populations are reviewed along with their potential efficacy in ameliorating disturbed biological pathways, particularly those mediating inflammation and oxidative stress. It is proposed that weight loss may not only be an effective intervention to enhance physical health but may also improve mental health outcomes and slow the rate of neuroprogressive disturbances in psychiatric disorders. Areas of future research to help expand our understanding of the relationship between obesity and psychiatric disorders are also outlined.
肥胖的发生率在一系列精神疾病中高于正常水平，包括重度抑郁症、双相情感障碍、精神分裂症和焦虑障碍。虽然肥胖问题在精神健康研究和治疗中已得到普遍认可，但对其双向关系的理解仍在不断发展。在这篇综述中，总结了肥胖与精神疾病之间的关联，特别强调了它们在紊乱的生物学途径上的相似性；即神经递质失衡、下丘脑-垂体-肾上腺轴紊乱、炎症途径失调、氧化和硝化应激增加、线粒体紊乱和神经进展。还回顾了减肥干预措施在精神科人群中的适用性和有效性，以及它们在改善紊乱的生物学途径方面的潜在疗效，特别是在调节炎症和氧化应激方面。有人提出，减肥不仅是增强身体健康的有效干预措施，还可能改善心理健康结果，并减缓精神疾病中神经进展紊乱的速度。还概述了未来有助于扩展我们对肥胖与精神疾病之间关系的理解的研究领域。
