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心理治疗与遗传神经科学:一场新兴的对话

Psychotherapy and Genetic Neuroscience: An Emerging Dialog.

作者信息

Jiménez Juan P, Botto Alberto, Herrera Luisa, Leighton Caroline, Rossi José L, Quevedo Yamil, Silva Jaime R, Martínez Felipe, Assar Rodrigo, Salazar Luis A, Ortiz Manuel, Ríos Ulises, Barros Paulina, Jaramillo Karina, Luyten Patrick

机构信息

Department of Psychiatry and Mental Health - East, Faculty of Medicine, Universidad de Chile, Santiago, Chile.

Human Genetics Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Santiago, Chile.

出版信息

Front Genet. 2018 Jul 17;9:257. doi: 10.3389/fgene.2018.00257. eCollection 2018.

Abstract

Recent research in psychiatric genetics has led to a move away from simple diathesis-stress models to more complex models of psychopathology incorporating a focus on gene-environment interactions and epigenetics. Our increased understanding of the way biology encodes the impact of life events on organisms has also generated more sophisticated theoretical models concerning the molecular processes at the interface between "nature" and "nurture." There is also increasing consensus that psychotherapy entails a specific type of learning in the context of an emotional relationship (i.e., the therapeutic relationship) that may also lead to epigenetic modifications across different therapeutic treatment modalities. This paper provides a systematic review of this emerging body of research. It is concluded that, although the evidence is still limited at this stage, extant research does indeed suggest that psychotherapy may be associated with epigenetic changes. Furthermore, it is argued that epigenetic studies may play a key role in the identification of biomarkers implicated in vulnerability for psychopathology, and thus may improve diagnosis and open up future research opportunities regarding the mechanism of action of psychotropic drugs as well as psychotherapy. We review evidence suggesting there may be important individual differences in susceptibility to environmental input, including psychotherapy. In addition, given that there is increasing evidence for the transgenerational transmission of epigenetic modifications in animals and humans exposed to trauma and adversity, epigenetic changes produced by psychotherapy may also potentially be passed on to the next generation, which opens up new perspective for prevention science. We conclude this paper stressing the limitations of current research and by proposing a set of recommendations for future research in this area.

摘要

近期精神病遗传学研究已促使人们从简单的素质-应激模型转向更复杂的精神病理学模型,这些模型注重基因-环境相互作用和表观遗传学。我们对生物学编码生活事件对生物体影响方式的理解不断加深,这也催生了关于“天性”与“教养”界面分子过程的更复杂理论模型。人们也越来越达成共识,心理治疗在情感关系(即治疗关系)背景下涉及一种特定类型的学习,这也可能导致不同治疗方式下的表观遗传修饰。本文对这一新兴研究领域进行了系统综述。得出的结论是,尽管现阶段证据仍然有限,但现有研究确实表明心理治疗可能与表观遗传变化有关。此外,有人认为表观遗传学研究可能在识别与精神病理学易感性相关的生物标志物方面发挥关键作用,从而可能改善诊断,并为精神药物作用机制以及心理治疗开辟未来研究机会。我们回顾了表明对包括心理治疗在内的环境输入敏感性可能存在重要个体差异的证据。此外,鉴于越来越多的证据表明,遭受创伤和逆境的动物和人类中表观遗传修饰会发生代际传递,心理治疗产生的表观遗传变化也可能潜在地传递给下一代,这为预防科学开辟了新视角。我们在本文结尾强调了当前研究的局限性,并为该领域未来研究提出了一系列建议。

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