Bollen Jessica, Trick Leanne, Llewellyn David, Dickens Chris
Mental Health Research Group, University of Exeter Medical School, College House, St Luke's Campus, Exeter EX1 2LU, United Kingdom.
Mental Health Research Group, University of Exeter Medical School, College House, St Luke's Campus, Exeter EX1 2LU, United Kingdom.
J Psychosom Res. 2017 Mar;94:47-55. doi: 10.1016/j.jpsychores.2017.01.002. Epub 2017 Jan 4.
The cognitive neuropsychological model of depression proposes that negative biases in the processing of emotionally salient information have a central role in the development and maintenance of depression. We have conducted a systematic review to determine whether acute experimental inflammation is associated with changes to cognitive and emotional processing that are thought to cause and maintain depression.
We identified experimental studies in which healthy individuals were administered an acute inflammatory challenge (bacterial endotoxin/vaccination) and standardised tests of cognitive function were performed.
Fourteen references were identified, reporting findings from 12 independent studies on 345 participants. Methodological quality was rated strong or moderate for 11 studies. Acute experimental inflammation was triggered using a variety of agents (including endotoxin from E. coli, S. typhi, S. abortus Equi and Hepatitis B vaccine) and cognition was assessed over hours to months, using cognitive tests of i) attention/executive functioning, ii) memory and iii) social/emotional processing. Studies found mixed evidence that acute experimental inflammation caused changes to attention/executive functioning (2 of 6 studies showed improvements in attention executive function compared to control), changes in memory (3 of 5 studies; improved reaction time: reduced memory for object proximity: poorer immediate and delayed memory) and changes to social/emotional processing (4 of 5 studies; reduced perception of emotions, increased avoidance of punishment/loss experiences, and increased social disconnectedness).
Acute experimental inflammation causes negative biases in social and emotional processing that could explain observed associations between inflammation and depression.
抑郁症的认知神经心理学模型提出，在处理情绪突出信息时的负性偏差在抑郁症的发生和维持中起核心作用。我们进行了一项系统评价，以确定急性实验性炎症是否与被认为会导致和维持抑郁症的认知和情绪加工变化有关。
我们确定了一些实验研究，其中对健康个体进行急性炎症刺激（细菌内毒素/接种疫苗），并进行认知功能标准化测试。
共确定了14篇参考文献，报告了12项关于345名参与者的独立研究结果。11项研究的方法学质量被评为强或中等。急性实验性炎症通过多种试剂引发（包括大肠杆菌、伤寒杆菌、马流产沙门氏菌的内毒素和乙肝疫苗），并在数小时至数月内使用以下认知测试评估认知：i）注意力/执行功能，ii）记忆，iii）社会/情绪加工。研究发现证据不一，急性实验性炎症导致注意力/执行功能发生变化（6项研究中有2项显示与对照组相比注意力执行功能有所改善）、记忆变化（5项研究中有3项；反应时间改善：物体接近度记忆降低：即时和延迟记忆较差）以及社会/情绪加工变化（5项研究中有4项；情绪感知降低、对惩罚/损失经历的回避增加以及社会脱节增加）。
急性实验性炎症会导致社会和情绪加工中的负性偏差，这可以解释观察到的炎症与抑郁症之间的关联。
