Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Dartmouth Hitchcock Medical Center, Lebanon, NH, 03766, USA.
Curr Psychiatry Rep. 2024 Oct;26(10):514-529. doi: 10.1007/s11920-024-01526-z. Epub 2024 Aug 27.
We evaluate available evidence for the role of inflammation in depression. We reappraise literature involving systemic inflammation, neuroinflammation and neurotransmission and their association with depression. We review the connection between depression, autoimmunity and infectious diseases. We revise anti-inflammatory treatments used in depression.
Peripheral inflammatory markers are present in a subset of patients with depression and can alter common neurotransmitters in this population but there is no clear causality between depression and systemic inflammation. Infectious conditions and autoimmune illnesses do not have a clear correlation with depression. Certain medications have positive evidence as adjunctive treatments in depression but studies are heterogenic, hence they are sparsely used in clinical settings. The current evidence does not fully support inflammation, infections or autoimmunity as possible etiologies of depression. The available studies have numerous confounders that obscure the findings. Anti-inflammatory agents may have potential for treatment of depression, but further research is needed to clarify their usefulness in routine clinical practice.
评估炎症在抑郁症中的作用的现有证据。我们重新评估涉及全身炎症、神经炎症和神经递质及其与抑郁症的关系的文献。我们综述了抑郁症、自身免疫和传染病之间的联系。我们修订了用于治疗抑郁症的抗炎药物。
在一部分抑郁症患者中存在外周炎症标志物，并且可以改变该人群中常见的神经递质，但抑郁症和全身炎症之间没有明确的因果关系。传染病和自身免疫性疾病与抑郁症没有明确的相关性。某些药物作为抑郁症的辅助治疗具有阳性证据，但研究存在异质性，因此在临床实践中很少使用。目前的证据并不能完全支持炎症、感染或自身免疫是抑郁症的可能病因。现有研究存在许多混杂因素，掩盖了研究结果。抗炎药物可能具有治疗抑郁症的潜力，但需要进一步研究以阐明其在常规临床实践中的用途。
