Durdurak Buse Beril, Morales-Muñoz Isabel, de Cates Angharad N, Wiseman Chantelle, Broome Matthew R, Marwaha Steven
Institute for Mental Health, University of Birmingham, Edgbaston, Birmingham, United Kingdom.
Coventry and Warwickshire NHS Partnership Trust, Coventry, United Kingdom.
Front Psychiatry. 2025 May 9;16:1552992. doi: 10.3389/fpsyt.2025.1552992. eCollection 2025.
Difficulties with emotion regulation (ER) are a key feature of bipolar disorder (BD) contributing to poor psychosocial and functional outcomes. Abnormalities within emotion processing and regulation thus provide key targets for treatment strategies and have implications for treatment response. Although biological mechanisms and ER are typically studied independently, emergent findings in BD research suggest that there are important ties between biological mechanisms and the disturbances in ER observed in BD. Therefore, in this narrative review, we provide an overview of the literature on biological mechanisms underlying emotional dysregulation in BD including genetic and epigenetic mechanisms, neuroimaging findings, inflammation, hypothalamic-pituitary-adrenal (HPA) axis dysfunction, neuroplasticity and brain-derived neurotrophic factor (BDNF), and circadian rhythm disturbances. Finally, we discuss the clinical relevance of the findings and provide future directions for research. The continued exploration of underlying biological mechanisms in ED in BD may not only elucidate fundamental neurobiological mechanisms but also foster advancements in current treatment strategies and the development of novel targeted treatments.
情绪调节（ER）困难是双相情感障碍（BD）的一个关键特征，会导致不良的心理社会和功能结果。因此，情绪处理和调节异常为治疗策略提供了关键靶点，并对治疗反应产生影响。尽管生物机制和情绪调节通常是独立研究的，但双相情感障碍研究中的新发现表明，生物机制与双相情感障碍中观察到的情绪调节障碍之间存在重要联系。因此，在这篇叙述性综述中，我们概述了双相情感障碍中情绪调节异常背后的生物机制的文献，包括遗传和表观遗传机制、神经影像学发现、炎症、下丘脑 - 垂体 - 肾上腺（HPA）轴功能障碍、神经可塑性和脑源性神经营养因子（BDNF）以及昼夜节律紊乱。最后，我们讨论了这些发现的临床相关性，并提供了未来的研究方向。对双相情感障碍中情绪调节障碍潜在生物机制的持续探索不仅可能阐明基本的神经生物学机制，还可能促进当前治疗策略的进步和新型靶向治疗的开发。
