Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy; Centro Lucio Bini, Rome, Italy.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA; Michael E. DeBakey VA Medical Center, Houston, TX, USA.
Psychiatr Clin North Am. 2020 Mar;43(1):139-151. doi: 10.1016/j.psc.2019.10.013. Epub 2019 Dec 10.
Interest in the coexistence of manic and depressive symptoms fostered hypotheses on neurobiological underpinnings of mixed states. Neurobiological properties of mixed states, however, have not been comprehensively described. The authors searched databases for articles on neurobiological markers related to mixed states. Results showed that mixed states are characterized by elevated central and peripheral monoamine levels, greater alterations in hypothalamic-pituitary-adrenal axis, increased inflammation, and greater circadian rhythms dysfunction than nonmixed forms. Furthermore, the magnitude of pathophysiologic alterations in mixed states exceeds those associated with nonmixed mania or depression and suggest that hyperactivation and hyperarousal are core features of mixed states.
人们对躁狂和抑郁症状共存的兴趣催生了关于混合状态神经生物学基础的假说。然而，混合状态的神经生物学特性尚未得到全面描述。作者在数据库中搜索了与混合状态相关的神经生物学标志物的文章。结果表明，混合状态的特征是中枢和外周单胺水平升高，下丘脑-垂体-肾上腺轴改变更大，炎症增加，昼夜节律功能障碍更严重，与非混合形式相比。此外，混合状态的病理生理改变程度超过了非混合躁狂或抑郁相关的改变，这表明过度兴奋和过度觉醒是混合状态的核心特征。
