Guo Weilong, Liu Jin, Li Lingjiang
Institute of Mental Health, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Apr 28;45(4):462-468. doi: 10.11817/j.issn.1672-7347.2020.190699.
Major depressive disorder (MDD) is a main type of mood disorder, characterized by significant and lasting depressed mood. Until now, the pathogenesis of MDD is not clear, but it is certain that biological, psychological, and social factors are involved. Childhood trauma is considered to be an important factor in the development of this disease. Previous studies have found that nearly half of the patients with MDD have experienced childhood trauma, and different types of childhood trauma, gender, and age show different effects on this disease. In addition, the clinical characteristics of MDD patients with childhood trauma are also different, which often have more severe depressive symptoms, higher risk of suicide, and more severe cognitive impairment. The response to antidepressants is also worse. In terms of biological mechanisms and marker characteristics, the serotonin transporter gene and the FKBP prolyl isomerase 5 have been shown to play an important role in MDD and childhood trauma. Moreover, some brain imaging and biomarkers showed specific features, such as changes in gray matter in the dorsal lateral prefrontal cortex, and abnormal changes in hypothalamic-pituitary-adrenal axis function.
重度抑郁症（MDD）是心境障碍的一种主要类型，其特征为显著且持久的抑郁情绪。到目前为止，MDD的发病机制尚不清楚，但可以确定的是，生物、心理和社会因素都与之相关。童年创伤被认为是该疾病发展的一个重要因素。先前的研究发现，近一半的MDD患者曾经历过童年创伤，并且不同类型的童年创伤、性别和年龄对该疾病有不同的影响。此外，有童年创伤的MDD患者的临床特征也有所不同，他们往往有更严重的抑郁症状、更高的自杀风险以及更严重的认知障碍。对抗抑郁药的反应也更差。在生物学机制和标志物特征方面，血清素转运体基因和FK506结合蛋白脯氨酰异构酶5已被证明在MDD和童年创伤中起重要作用。此外，一些脑成像和生物标志物显示出特定特征，如下背外侧前额叶皮质灰质的变化以及下丘脑-垂体-肾上腺轴功能的异常变化。
