Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Vitam Horm. 2023;122:307-337. doi: 10.1016/bs.vh.2023.01.004. Epub 2023 Feb 9.
Different factors are essential in increasing the vulnerability to psychiatric disorders, such as genetics. Among these factors, early life stress (ELS), including sexual, physical, emotional abuse, and emotional and physical neglect, enhances the odds of having menial conditions throughout life. Exhaustive research has shown that ELS leads to physiological changes, such as alteration in the HPA axis. During the most critical development period (childhood and adolescence), these changes increase the risk of having child-onset psychiatric disorders. Furthermore, research has suggested a relationship between early life stress and depression, particularly more prolonged episodes of depression with treatment-resistant outcomes. Molecular studies indicate that, in general, the hereditary character of psychiatric disorders is polygenic, multifactorial and highly complex, with innumerable low-effect genetic variants interacting with each other. However, whether there are independent effects among subtypes of ELS remains unclear. This article provides an overview of the interplay of epigenetics, the HPA axis, early life stress and the development of depression. Advances in our knowledge of epigenetics in the context of early life stress and depression provide a new understanding of the genetic influence on psychopathology. Furthermore, they could lead to identifying new targets for clinical intervention.
不同的因素在增加精神障碍的易感性方面至关重要,如遗传学。在这些因素中,早期生活应激(ELS),包括性、身体、情感虐待以及情感和身体忽视,增加了一生中出现轻度疾病的几率。大量研究表明,ELS 会导致生理变化,如 HPA 轴的改变。在最关键的发育时期(儿童期和青春期),这些变化会增加儿童期起病的精神障碍的风险。此外,研究表明早期生活应激与抑郁症之间存在关系,特别是治疗抵抗的更持久的抑郁发作。分子研究表明,一般来说,精神障碍的遗传特征是多基因、多因素和高度复杂的,无数低影响的遗传变异相互作用。然而,ELS 的亚型之间是否存在独立影响仍不清楚。本文概述了表观遗传学、HPA 轴、早期生活应激和抑郁症发展之间的相互作用。我们对早期生活应激和抑郁症背景下的表观遗传学的认识的进步为遗传对精神病理学的影响提供了新的理解。此外,它们可能导致确定新的临床干预靶点。