Kaltenboeck Alexander, Harmer Catherine
Psychopharmacology and Emotion Research Laboratory (PERL), Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Brain Neurosci Adv. 2018 Oct 8;2:2398212818799269. doi: 10.1177/2398212818799269. eCollection 2018 Jan-Dec.
Depression is a common and debilitating mental health condition whose underlying aetiology and pathophysiology is still relatively poorly understood. In this article, we first turn to the past and briefly review what neuroscientific investigations have taught us so far about depression. In doing so, we cover neurochemical, neuroendocrine, immunological, functional and structural anatomical, and cognitive levels of description. We then turn our attention to the future and discuss where the field might be moving in the years to come. We argue that future developments may rely on three important lines of enquiry: first, the development of an integrated neuroscientific model of depression and its treatment in which different levels of description can be mechanistically linked, and in which distinct pathophysiological trajectories leading to depressive symptomatology can be identified. Second, the continued search for potentially overlooked pathophysiological factors, especially outside the immediate boundaries of the brain. And third, the improvement in translation of neuroscientific insights to aid and advance clinical practice and research.
抑郁症是一种常见且使人衰弱的心理健康状况,其潜在病因和病理生理学仍相对了解不足。在本文中,我们首先回顾过去,简要概述神经科学研究迄今教给我们的有关抑郁症的知识。在此过程中,我们涵盖了神经化学、神经内分泌、免疫学、功能和结构解剖学以及认知层面的描述。然后我们将注意力转向未来,讨论该领域在未来几年可能的发展方向。我们认为,未来的发展可能依赖于三条重要的研究路线:第一,建立一个综合的抑郁症神经科学模型及其治疗方法,其中不同层面的描述可以建立起机制联系,并且能够识别导致抑郁症状的不同病理生理轨迹。第二,持续寻找可能被忽视的病理生理因素,尤其是在大脑直接范围之外的因素。第三,改善神经科学见解的转化,以辅助和推进临床实践与研究。