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评估儿童期创伤、C 反应蛋白与情感障碍患者抗抑郁治疗反应之间的关系。

Assessing the links between childhood trauma, C-reactive protein and response to antidepressant treatment in patients with affective disorders.

机构信息

Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nußbaumstraße 7, 80336, München, Germany.

Institute of Mental Health at UBC, University of British Columbia, Vancouver, Canada.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2021 Oct;271(7):1331-1341. doi: 10.1007/s00406-021-01245-z. Epub 2021 Mar 17.

Abstract

Adverse Childhood Experiences (ACE) are a well-known risk-factor for depression. Additionally, (high-sensitive) C-reactive Protein (hsCRP) is elevated in subgroups of depressed patients and high following ACE. In this context the literature considers hsCRP and ACE to be associated with treatment resistant depression. With the data being heterogenous, this study aimed to explore the associations of ACE, hsCRP levels and response to antidepressant treatment in uni- and bipolar depression. N = 76 patients diagnosed with uni- or bipolar depression and N = 53 healthy controls were included. Treatment was over 6 weeks in an inpatient psychiatric setting within an observatory study design. Depressive symptoms were assessed by the Montgomery-Asberg Depression Rating Scale (MADRS), ACE were assessed by the Childhood Trauma Questionnaire (CTQ); the body-mass-index (BMI) and hsCRP were measured. HsCRP levels did not differ between the study population and the healthy controls. While the depressive symptoms decreased, the hsCRP levels increased. Sexual abuse was associated with significant higher and emotional abuse with lower levels of hsCRP after 6 weeks. The baseline hsCRP levels and the ACE subgroups did not show significant associations with the treatment response in unipolar depressed patients. The long-lasting effects of specific forms of ACE may have relevant impact on inflammation, supporting hsCRP to be a suitable biomarker. With ACE and hsCRP not showing any significant associations with treatment response in the unipolar depressed subgroup, a more differentiate research concerning biomarkers and treatment regimens is needed when talking about treatment response.

摘要

童年期逆境经历(ACE)是抑郁的一个众所周知的风险因素。此外,(高敏)C 反应蛋白(hsCRP)在抑郁患者亚组中升高,且在 ACE 后升高。在这种情况下,文献认为 hsCRP 和 ACE 与治疗抵抗性抑郁有关。由于数据存在异质性,本研究旨在探讨 ACE、hsCRP 水平与单相和双相抑郁患者抗抑郁治疗反应的关系。共纳入 76 例单相或双相抑郁患者和 53 名健康对照者。在观察性研究设计的住院精神病学环境中,进行为期 6 周的治疗。采用蒙哥马利-阿斯伯格抑郁评定量表(MADRS)评估抑郁症状,采用儿童创伤问卷(CTQ)评估 ACE;测量体重指数(BMI)和 hsCRP。研究人群与健康对照组的 hsCRP 水平无差异。随着抑郁症状的减轻,hsCRP 水平升高。6 周后,性虐待与 hsCRP 水平显著升高相关,情感虐待与 hsCRP 水平降低相关。hsCRP 基线水平和 ACE 亚组与单相抑郁患者的治疗反应无显著相关性。特定形式的 ACE 的长期影响可能对炎症有重要影响,支持 hsCRP 成为一种合适的生物标志物。由于 ACE 和 hsCRP 与单相抑郁亚组的治疗反应无显著相关性,因此在讨论治疗反应时,需要对生物标志物和治疗方案进行更具针对性的研究。

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Childhood trauma history is linked to abnormal brain connectivity in major depression.童年创伤史与重度抑郁症患者大脑连接异常有关。
Proc Natl Acad Sci U S A. 2019 Apr 23;116(17):8582-8590. doi: 10.1073/pnas.1900801116. Epub 2019 Apr 8.

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