Department of Psychiatry, Women's Mood Disorders Center, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA.
Front Neuroendocrinol. 2019 Jan;52:165-180. doi: 10.1016/j.yfrne.2018.12.001. Epub 2018 Dec 12.
This review aims to summarize the diverse proposed pathophysiological mechanisms contributing to postpartum depression, highlighting both clinical and basic science research findings. The risk factors for developing postpartum depression are discussed, which may provide insight into potential neurobiological underpinnings. The evidence supporting a role for neuroendocrine changes, neuroinflammation, neurotransmitter alterations, circuit dysfunction, and the involvement of genetics and epigenetics in the pathophysiology of postpartum depression are discussed. This review integrates clinical and preclinical findings and highlights the diversity in the patient population, in which numerous pathophysiological changes may contribute to this disorder. Finally, we attempt to integrate these findings to understand how diverse neurobiological changes may contribute to a common pathological phenotype. This review is meant to serve as a comprehensive resource reviewing the proposed pathophysiological mechanisms underlying postpartum depression.
本次综述旨在总结导致产后抑郁症的多种提出的病理生理机制,重点介绍临床和基础科学研究发现。讨论了发生产后抑郁症的风险因素,这可能为潜在的神经生物学基础提供一些见解。讨论了支持神经内分泌变化、神经炎症、神经递质改变、回路功能障碍以及遗传学和表观遗传学在产后抑郁症病理生理学中作用的证据。本综述整合了临床和临床前的发现,并强调了患者人群的多样性,其中许多病理生理变化可能导致这种疾病。最后,我们试图整合这些发现,以了解多种神经生物学变化如何共同导致一种常见的病理表型。本综述旨在作为一个全面的资源,综述产后抑郁症潜在病理生理机制的提出。