School of Psychiatry, University of New South Wales, Australia.
Brain Behav Immun. 2015 Oct;49:18-24. doi: 10.1016/j.bbi.2015.02.025. Epub 2015 Mar 5.
Depression emerging in conjunction with acute coronary syndrome (ACS) is thought to constitute a distinct high-risk phenotype with inflammatory determinants. This review critically examines the notion put forward in the literature that ACS-associated depression constitutes a meaningful subtype that is qualitatively different from depressive syndromes observed in psychiatric patients; and evaluates the salience of an analogy to the acute sickness response to infection or injury as an explanatory model. Specific features differentiating ACS-associated depression from other phenotypes are discussed, including differences in depression symptom profiles, timing of the depressive episode in relation to ACS, severity of the cardiac event, and associated immune activation. While an acute sickness response analogy offers a plausible conceptual framework, concrete evidence is lacking for inflammatory activity as the triggering mechanism. It is likely that ACS-associated depression encompasses several causative scenarios.
与急性冠状动脉综合征（ACS）同时出现的抑郁症被认为是一种具有炎症决定因素的独特高风险表型。这篇综述批判性地考察了文献中提出的观点，即 ACS 相关的抑郁症构成了一种有意义的亚型，与精神科患者中观察到的抑郁综合征在性质上有所不同；并评估了将其与感染或损伤后的急性疾病反应相类比作为一种解释模型的重要性。讨论了将 ACS 相关的抑郁症与其他表型区分开来的具体特征，包括抑郁症状谱、抑郁发作与 ACS 的关系、心脏事件的严重程度以及相关的免疫激活方面的差异。虽然急性疾病反应类比提供了一个合理的概念框架，但缺乏炎症活动作为触发机制的具体证据。ACS 相关的抑郁症可能包含几种致病情况。
