Schlosser Nicole, Wolf Oliver T, Wingenfeld Katja
a Department of Psychiatry and Psychotherapy, Evangelisch Hospital Bielefeld, Remterweg 69-71, D-33617 Bielefeld, Germany.
b Department of Cognitive Psychology, Ruhr-University Bochum, Universitätsstr. 150, D-44780 Bochum, Germany.
Expert Rev Endocrinol Metab. 2011 Jan;6(1):109-126. doi: 10.1586/eem.10.79.
Depressive disorder has become a major health problem and is ranked among the leading causes of disability worldwide. Depression-related cognitive impairment contributes to loss of economic productivity and psychosocial functioning and calls for more efficient treatment strategies. Although the pathogenesis of cognitive impairments in patients with major depressive disorder (MDD) is still insufficiently understood, increasing evidence implicates hypothalamus-pituitary-adrenal (HPA) axis as an important neurobiological determinant of cognitive impairment in depression. In this article, major findings of both HPA axis function abnormalities and cognitive impairments in depressed patients are summarized, focusing on their inter-relationship. Novel approaches in pharmacotherapy and psychotherapy have emerged which will be discussed with regard to their ability to reinstate normal HPA axis function in MDD and to treat cognitive impairments in MDD.
抑郁症已成为一个主要的健康问题，在全球致残的主要原因中名列前茅。与抑郁症相关的认知障碍会导致经济生产力和社会心理功能丧失，因此需要更有效的治疗策略。尽管目前对重度抑郁症（MDD）患者认知障碍的发病机制仍了解不足，但越来越多的证据表明，下丘脑 - 垂体 - 肾上腺（HPA）轴是抑郁症认知障碍的一个重要神经生物学决定因素。本文总结了抑郁症患者HPA轴功能异常和认知障碍的主要研究结果，重点关注它们之间的相互关系。还出现了药物治疗和心理治疗的新方法，将讨论它们恢复MDD患者正常HPA轴功能以及治疗MDD认知障碍的能力。
