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[焦虑症——临床与神经生物学方面]

[Anxiety disorders - clinical and neurobiological aspects].

作者信息

Lahousen Theresa, Kapfhammer Hans-Peter

机构信息

Klinik für Psychiatrie und Psychotherapeutische Medizin, Medizinische Universität Graz, Auenbruggerplatz 31, A-8036 Graz, Austria.

出版信息

Psychiatr Danub. 2018 Dec;30(4):479-490. doi: 10.24869/psyd.2018.479.

Abstract

Anxiety disorders are considered among the most common psychiatric disorders in general population. They may be characterized by prominent subjective suffering, frequent chronic courses of illness, increased rates of comorbid other psychiatric disorders and somatic diseases, a distressing amount of psychosocial disabilities, in all, a challenging high burden of disease. Anxiety disorders have principally to be conceptualized within a multifactorial biopsychosocial model. Various psychological and psychosocial approaches have contributed to a multi-layered understanding of various major predisposing, eliciting, and maintaining factors in the course of illness. Modern neurobiological research has significantly broadened and deepened the aetiopathogenetic complexity of anxiety disorders. The main focus of this short review is on neural fear- and anxiety circuits, neurotransmitter systems, neuroendocrine and inflammatory stress systems, genetics and epigenetics that characterize the general basis of fear and anxiety regulation and their dysregulation in anxiety disorders. Anxiety disorders may be effectively treated both by psychotherapeutic and pharmacological approaches. Basic principles and general guidelines in the treatment of anxiety disorders are being presented.

摘要

焦虑症被认为是普通人群中最常见的精神疾病之一。其特征可能包括显著的主观痛苦、频繁的慢性病程、其他精神疾病和躯体疾病共病率增加、令人痛苦的心理社会残疾数量,总体而言,是一种具有挑战性的高疾病负担。焦虑症主要应在多因素生物心理社会模型中进行概念化。各种心理和社会心理方法有助于对疾病过程中各种主要的易患、诱发和维持因素进行多层次的理解。现代神经生物学研究显著拓宽和加深了焦虑症病因发病机制的复杂性。本简短综述的主要重点是神经恐惧和焦虑回路、神经递质系统、神经内分泌和炎症应激系统、遗传学和表观遗传学,这些构成了恐惧和焦虑调节的一般基础及其在焦虑症中的失调。焦虑症可以通过心理治疗和药物治疗方法得到有效治疗。本文介绍了焦虑症治疗的基本原则和一般指南。

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