Jawad Muhammad Youshay, Fatima Maurish, Hassan Umer, Zaheer Zaofashan, Ayyan Muhammad, Ehsan Muhammad, Khan Muhmmad Huzaifa Ahmed, Qadeer Ahsan, Gull Abdul Rehman, Asif Muhammad Talha, Shad Mujeeb U
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
King Edward Medical University, Lahore, Pakistan.
Hum Psychopharmacol. 2023 Jul;38(4):e2871. doi: 10.1002/hup.2871. Epub 2023 May 15.
Despite frequent recognition of emotional blunting in the published literature, either as a primary symptom of depression or as an adverse effect of antidepressants, there is no systematic synthesis on this topic to our knowledge. We undertook this scoping review to assess the prevalence, clinical features, implicated causes and management of emotional blunting, outlining the phenomenological and clinical gaps in research.
A systematic search was done until March 15, 2022, to include all original studies (i.e., interventional trials, cohort & cross-sectional studies, case reports, and case series). All reviewed data were delineated to answer pertinent clinical, phenomenological, and management questions related to the phenomenon of emotional blunting.
A total of 25 original studies were included in our scoping review. Emotional blunting was described as a persistent diminution in both positive and negative feelings in depressed patients, who could subjectively differentiate it from their acute symptoms. However, the literature lacked the distinction between emotional blunting as a primary symptom of depression or an adverse effect of antidepressants. Common clinical strategies to manage antidepressant-induced emotional blunting included dose reduction or switching to a different antidepressant.
Emotional blunting was a significant patient-reported concern with antidepressants. Future research should clarify phenomenological and neurobiological constructs underlying emotional blunting to improve diagnostic and management skills.
尽管在已发表的文献中经常认识到情感迟钝，无论是作为抑郁症的主要症状还是作为抗抑郁药的不良反应，但据我们所知，关于这个主题没有系统的综述。我们进行了这项范围综述，以评估情感迟钝的患病率、临床特征、相关原因和管理，概述研究中的现象学和临床差距。
进行了系统检索，直至2022年3月15日，纳入所有原创研究（即干预试验、队列研究和横断面研究、病例报告和病例系列）。所有综述数据都进行了描述，以回答与情感迟钝现象相关的相关临床、现象学和管理问题。
我们的范围综述共纳入了25项原创研究。情感迟钝被描述为抑郁症患者积极和消极情绪的持续减少，患者能够主观地将其与急性症状区分开来。然而，文献中缺乏情感迟钝作为抑郁症主要症状或抗抑郁药不良反应之间的区分。管理抗抑郁药引起的情感迟钝的常见临床策略包括减少剂量或换用不同的抗抑郁药。
情感迟钝是患者报告的与抗抑郁药相关的一个重要问题。未来的研究应阐明情感迟钝背后的现象学和神经生物学结构，以提高诊断和管理技能。
