Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
J Psychiatr Res. 2019 Jun;113:148-158. doi: 10.1016/j.jpsychires.2019.02.005. Epub 2019 Feb 10.
Increasingly, clinical research has found inflammatory correlates of psychiatric disorders, particularly mood symptomatology. Biological measures may provide greater precision in many cases and may capture clinically-relevant inflammatory signposts, such as central obesity risk, inflammation-associated co-morbid medical conditions, or proinflammatory lifestyle choices. In order to expand understanding of the role of inflammation in mood disorders, we propose a more inclusive clinical model for capturing an inflammatory phenotype of depression by identifying clinically-relevant inflammatory phenotypes grounded in biology. Our model includes chronic conditions and lifestyle behaviors associated with clinically elevated inflammation in mood disorders. Elements of this "inflamed depression" model include: obesity, low HDL concentrations, elevated triglyceride concentrations, chronically elevated blood pressure, clinical diagnosis of hypothyroidism, migraines, rheumatoid arthritis, adult onset diabetes, inflammatory bowel diseases, inflammatory skin conditions, and lifestyle factors including smoking cigarettes and chronic stress.
越来越多的临床研究发现,精神疾病,尤其是情绪症状,与炎症有关。在许多情况下,生物标志物可能会提供更高的精确度,并可能捕捉到临床相关的炎症标志,如中心性肥胖风险、与炎症相关的合并症医疗状况,或促炎的生活方式选择。为了扩大对炎症在情绪障碍中的作用的理解,我们提出了一种更具包容性的临床模型,通过确定基于生物学的临床相关炎症表型来捕捉抑郁症的炎症表型。我们的模型包括与情绪障碍中临床炎症升高相关的慢性疾病和生活方式行为。这个“炎症性抑郁症”模型的要素包括:肥胖、低高密度脂蛋白浓度、甘油三酯浓度升高、血压持续升高、临床诊断的甲状腺功能减退症、偏头痛、类风湿性关节炎、成人发病型糖尿病、炎症性肠病、炎症性皮肤疾病,以及包括吸烟和慢性压力在内的生活方式因素。