Lou Yixue, Lei Yi, Mei Ying, Leppänen Paavo H T, Li Hong
College of Psychology and Sociology, Shenzhen University, Shenzhen, China.
Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland.
Front Psychiatry. 2019 Mar 28;10:130. doi: 10.3389/fpsyt.2019.00130. eCollection 2019.
Major depressive disorder (MDD) is an affective disorder that is harmful to both physical and mental health. Abnormal self-knowledge, which refers to abnormal judgments about oneself, is a core symptom of depression. However, little research has summarized how and why patients with MDD differ from healthy individuals in terms of self-knowledge. To gain a better understanding of MDD, we reviewed previous studies that focused on the behavioral and neurological changes of self-knowledge in this illness. On the behavioral level, depressed individuals exhibited negative self-knowledge in an explicit way, while more heterogeneous patterns were reported in implicit results. On the neurological level, depressed individuals, as compared with non-depressed controls, showed abnormal self-referential processing in both early perception and higher cognitive processing phases during the Self-Referential Encoding Task. Furthermore, fMRI studies have reported aberrant activity in the medial prefrontal cortex area for negative self-related items in depression. These results revealed several behavioral features and brain mechanisms underlying abnormal self-knowledge in depression. The neural mechanism of implicit self-knowledge in MDD remains unclear. Future research should examine the importance of others' attitudes on the self-concept of individuals with MDD, and whether abnormal self-views may be modified through cognitive or pharmacological approaches. In addition, differences in abnormal self-knowledge due to genetic variation between depressed and non-depressed populations remain unconfirmed. Importantly, it remains unknown whether abnormal self-knowledge could be used as a specific marker to distinguish healthy individuals from those with MDD. This review extends our understanding of the relationship between self-knowledge and depression by indicating several abnormalities among individuals with MDD and those who are at risk for this illness.
重度抑郁症（MDD）是一种对身心健康都有害的情感障碍。异常的自我认知，即对自己的异常判断，是抑郁症的核心症状。然而，很少有研究总结出MDD患者在自我认知方面与健康个体有何不同以及为何不同。为了更好地理解MDD，我们回顾了以往关注该疾病中自我认知的行为和神经变化的研究。在行为层面，抑郁个体以一种显性的方式表现出消极的自我认知，而在内隐结果方面则报告了更多样化的模式。在神经层面，与非抑郁对照组相比，抑郁个体在自我参照编码任务的早期感知和更高认知加工阶段均表现出异常的自我参照加工。此外，功能磁共振成像（fMRI）研究报告了抑郁症患者中与消极自我相关项目在内侧前额叶皮质区域的异常活动。这些结果揭示了抑郁症中异常自我认知背后的一些行为特征和脑机制。MDD中内隐自我认知的神经机制仍不清楚。未来的研究应考察他人态度对MDD患者自我概念的重要性，以及异常的自我观点是否可以通过认知或药物方法得到改善。此外，抑郁和非抑郁人群之间由于基因变异导致的异常自我认知差异仍未得到证实。重要的是，异常的自我认知是否可以作为区分健康个体和MDD患者的特定标志物仍然未知。这篇综述通过指出MDD患者以及有患该疾病风险的个体中的一些异常情况，扩展了我们对自我认知与抑郁症之间关系的理解。
