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揭示各种重度抑郁症阶段的内脏感知觉障碍。

Unveiling the interoception impairment in various major depressive disorder stages.

机构信息

Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi, China.

Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China.

出版信息

CNS Neurosci Ther. 2024 Aug;30(8):e14923. doi: 10.1111/cns.14923.

DOI:10.1111/cns.14923
PMID:39154365
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11330652/
Abstract

BACKGROUND

The intricate pathophysiological mechanisms of major depressive disorder (MDD) necessitate the development of comprehensive early indicators that reflect the complex interplay of emotional, physical, and cognitive factors. Despite its potential to fulfill these criteria, interoception remains underexplored in MDD. This study aimed to evaluate the potential of interoception in transforming MDD's clinical practices by examining interoception deficits across various MDD stages and analyzing their complex associations with the spectrum of depressive symptoms.

METHODS

This study included 431 healthy individuals, 206 subclinical depression individuals, and 483 MDD patients. Depressive symptoms and interoception function were assessed using the PHQ-9 and MAIA-2, respectively.

RESULTS

Interoception dysfunction occurred in the preclinical phase of MDD and further impaired in the clinical stage. Antidepressant therapies showed limited efficacy in improving interoception and might damage some dimensions. Interoceptive dimensions might predict depressive symptoms, primarily enhancing negative thinking patterns. The predictive model based on interoception was built with random split verification and demonstrated good discrimination and predictive performance in identifying MDD.

CONCLUSIONS

Early alterations in the preclinical stage, multivariate associations with depressive symptoms, and good discrimination and predictive performance highlight the importance of interoception in MDD management, pointing to a paradigm shift in diagnostic and therapeutic approaches.

摘要

背景

重度抑郁症（MDD）的复杂病理生理机制需要开发综合的早期指标，以反映情感、身体和认知因素的复杂相互作用。尽管内感受在这方面具有潜力，但在 MDD 中仍未得到充分探索。本研究旨在通过检查 MDD 各阶段的内感受缺陷，并分析其与抑郁症状谱的复杂关联，评估内感受在改变 MDD 临床实践中的潜力。

方法

本研究纳入了 431 名健康个体、206 名亚临床抑郁个体和 483 名 MDD 患者。使用 PHQ-9 和 MAIA-2 分别评估抑郁症状和内感受功能。

结果

内感受功能障碍发生在 MDD 的临床前阶段，并在临床阶段进一步受损。抗抑郁治疗对改善内感受的效果有限，并且可能会损害某些维度。内感受维度可能预测抑郁症状，主要是增强消极的思维模式。基于内感受的预测模型通过随机拆分验证构建，在识别 MDD 方面表现出良好的区分度和预测性能。

结论

在临床前阶段的早期改变、与抑郁症状的多变量关联，以及良好的区分度和预测性能，突显了内感受在 MDD 管理中的重要性，这标志着诊断和治疗方法的范式转变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/e96ef4874ede/CNS-30-e14923-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/43e1889a75e7/CNS-30-e14923-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/8f14da61f9e1/CNS-30-e14923-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/4d209c86ef81/CNS-30-e14923-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/7269d4ea5387/CNS-30-e14923-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/e96ef4874ede/CNS-30-e14923-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/43e1889a75e7/CNS-30-e14923-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/8f14da61f9e1/CNS-30-e14923-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/4d209c86ef81/CNS-30-e14923-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/7269d4ea5387/CNS-30-e14923-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/926e/11330652/e96ef4874ede/CNS-30-e14923-g001.jpg

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