Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37212, USA; email:
Geriatric Research, Education, and Clinical Center, Tennessee Valley Veterans Affairs Medical Center, Nashville, Tennessee 37212, USA.
Annu Rev Clin Psychol. 2019 May 7;15:399-423. doi: 10.1146/annurev-clinpsy-050718-095557. Epub 2019 Feb 20.
This article reviews the interactions of estrogen changes and psychosocial stress in contributing to vulnerability to major depressive disorder (MDD) in women. Estrogen modulates brain networks and processes related to changes in stress response, cognition, and emotional dysregulation that are core characteristics of MDD. Synergistic effects of estrogen on cognitive and emotional function, particularly during psychosocial stress, may underlie the association of ovarian hormone fluctuation and depression in women. We propose a model of estrogen effects on multiple brain systems that interface with stress-related emotional and cognitive processes implicated in MDD and discuss possible mechanisms through which reproductive events and changes in estrogen may contribute to MDD risk in women with other concurrent risk factors.
本文综述了雌激素变化与社会心理压力相互作用,导致女性易患重度抑郁症(MDD)的机制。雌激素调节与应激反应、认知和情绪调节变化相关的大脑网络和过程,这些是 MDD 的核心特征。雌激素对认知和情绪功能的协同作用,特别是在社会心理压力期间,可能是卵巢激素波动与女性抑郁相关的基础。我们提出了一个雌激素对多个大脑系统影响的模型,这些系统与 MDD 中涉及的与应激相关的情绪和认知过程相互作用,并讨论了生殖事件和雌激素变化如何通过其他共存风险因素导致女性 MDD 风险增加的可能机制。