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城市环境与精神障碍:神经科学与生物学的综述。

Urban environment and psychiatric disorders: a review of the neuroscience and biology.

机构信息

Brazilian Brain Institute (INBRACER), Rio de Janeiro, Brazil.

Rio de Janeiro State University (UERJ), Institute of Social Medicine, Department of Health Policy and Management, Rio de Janeiro, Brazil.

出版信息

Metabolism. 2019 Nov;100S:153940. doi: 10.1016/j.metabol.2019.07.004.

Abstract

Most of the world's population now lives in cities. While living in cities have both health risks and benefits, mental health has been usually considered to be negatively affected by urbanicity. While mental health disorders have complex etiology and multiple causes, it has been shown in multiple observational studies that mood and anxiety disorders are more prevalent in urban centers and incidence has been increasing. In addition, the incidence of schizophrenia is strongly increased in people born and raised in cities. Studies on the effects of urbanicity on the brain, however, are more challenging to conduct, since individual and environmental factors are hard to distinguish. The main objective of this article is to review studies on how specific neural processes mediate those associations between urbanicity and psychiatric disorders and how environmental factors affect genetic regulation (epigenetics). Neuroimaging studies have shown how urban stressors might affect the brain by conducting experiments using functional magnetic resonance imaging (fMRI). There have been demonstrations that urban upbringing and city living have dissociable impacts on social evaluative stress processing in humans. City living was associated with increased amygdala activity and the urban upbringing has been shown to affect the perigenual anterior cingulate cortex, a key region for regulation of amygdala activity, negative affect and stress. In addition, studies on epigenetics have shown associations between exposure to features of the environment and methylation patterns. The goal of understanding how urban environments act as a risk factor for mental disorders may be pursued on several levels. It can be approached by measuring the effects of economic factors (unemployment, socioeconomic status), social condition (social network support), environmental exposures (toxins, air pollution, noise, light), that must be weighed to identify how it contributes to mental disorders.

摘要

现在,世界上大多数人口都居住在城市中。尽管城市生活既存在健康风险,也存在健康益处,但城市生活通常被认为会对心理健康产生负面影响。虽然精神健康障碍的病因复杂且有多种原因,但多项观察性研究表明,情绪和焦虑障碍在城市中心更为普遍,且发病率呈上升趋势。此外,在城市中出生和长大的人群中,精神分裂症的发病率也明显升高。然而,由于个体和环境因素难以区分,因此对城市环境对大脑影响的研究更具挑战性。本文的主要目的是综述研究,以了解城市生活与精神疾病之间的关联是如何通过特定的神经过程介导的,以及环境因素如何影响遗传调控(表观遗传学)。神经影像学研究通过使用功能磁共振成像(fMRI)进行实验,展示了城市压力源如何通过影响特定的神经过程来影响大脑。研究表明,城市养育和城市生活对人类的社会评价压力处理有不同的影响。城市生活与杏仁核活动增加有关,而城市养育已被证明会影响边缘前扣带回的旁区(perigenual anterior cingulate cortex),这是调节杏仁核活动、负性情绪和压力的关键区域。此外,表观遗传学研究表明,环境特征暴露与甲基化模式之间存在关联。了解城市环境如何成为精神障碍的风险因素,可以从多个层面进行探索。可以通过测量经济因素(失业、社会经济地位)、社会状况(社会网络支持)、环境暴露(毒素、空气污染、噪音、光)的影响来实现,这些因素必须加以权衡,以确定其对精神障碍的贡献。

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