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个体化抑郁障碍治疗策略。

Individualized Treatment Strategy for Depressive Disorder.

机构信息

Clinical Research Center and Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Psychiatry, First Affiliated Hospital' Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Adv Exp Med Biol. 2019;1180:219-232. doi: 10.1007/978-981-32-9271-0_12.

Abstract

The goal of treatment for depressive disorders is complete remission of depressive symptoms with full recovery of social function and prevention of recurrence. However, a large proportion of patients do not experience symptomatic remission after the initial treatment, with even lower rates of remission in the longer treatment term. The main objective of individualized treatment applied in psychiatry is to improve precision in disease diagnosis, prognosis, treatment choices, and treatment response. Diverse approaches and techniques, such as genomics, epigenomics, other omics, neural circuit, and artificial intelligence are related to precision psychiatry. Using biology and computational psychiatry tools to find potential biomarkers, and based on precision psychiatry, patients considered to belong to the same endophenotype will be possible to receive biomarkers-based treatment and better prognosis. Especially in the choice of intervention, individualized treatment should be considered. In this review, we present the development of precise treatment in depressive disorders and introduce advances in several domains toward precision medicine and individualized treatment. We pay particular attention to biomarkers and the development of new technologies in depressive disorders, which will help disease complete remission and functional recovery, seek better lives for patients suffered with depressive disorders.

摘要

治疗抑郁障碍的目标是完全缓解抑郁症状,全面恢复社会功能并预防复发。然而,很大一部分患者在初始治疗后并未出现症状缓解,在更长的治疗期间缓解率更低。精神病学中应用的个体化治疗的主要目标是提高疾病诊断、预后、治疗选择和治疗反应的准确性。基因组学、表观基因组学、其他组学、神经回路和人工智能等多种方法和技术都与精准精神病学相关。使用生物学和计算精神病学工具来寻找潜在的生物标志物,并基于精准精神病学,有可能对被认为属于相同表型的患者进行基于生物标志物的治疗和更好的预后。特别是在干预选择方面,应考虑个体化治疗。在这篇综述中,我们介绍了抑郁障碍精准治疗的发展,并介绍了精准医学和个体化治疗几个领域的进展。我们特别关注抑郁障碍中的生物标志物和新技术的发展,这将有助于疾病的完全缓解和功能恢复,为患有抑郁障碍的患者寻求更好的生活。

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