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生殖精神障碍的生物标志物。

Biomarkers of reproductive psychiatric disorders.

作者信息

Etyemez Semra, Mehta Kruti, Iyer Sonali, Özdemir İpek, Osborne Lauren M

机构信息

Department of Obstetrics & Gynecology, Weill Cornell Medical College, New York, NY, USA.

Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA.

出版信息

Br J Psychiatry. 2025 Jun;226(6):352-368. doi: 10.1192/bjp.2025.134. Epub 2025 Jun 20.

Abstract

BACKGROUND

While biomarkers are widely used in other medical fields, psychiatry has yet to introduce reliable biological diagnostic tools. Female reproductive transitions provide a unique window of opportunity for investigating psychiatric biomarkers. Hormonal changes across menstruation, pregnancy, parturition and perimenopause can have dramatic effects on mental health in vulnerable individuals, enabling the identification of unique biomarkers associated with these fluctuations.

AIMS

This review integrates current evidence concerning potential biomarkers, with focus on recent human studies in perinatal depression, anxiety and obsessive-compulsive disorder, postpartum psychosis, premenstrual dysphoric disorder and perimenopausal depression.

METHOD

We identified potential articles to be included in this narrative review by using PubMed to obtain articles in English since 2010 on the six conditions listed above, with the additional keywords of 'biomarker', 'epigenetics', 'neuroactive steroid', 'immune', 'inflammatory' and 'neuroimaging'.

RESULTS

There is substantial published evidence regarding potential biomarkers of reproductive psychiatric disorders in the areas of epigenetics, neuroactive steroids, immune function and neuroimaging. This body of research holds significant potential to advance biomarker development, uncover disease mechanisms and improve diagnostic and therapeutic strategies, but there is as yet no clinically useful biomarker in commercial development for any reproductive psychiatric disorder.

CONCLUSION

There is an urgent need for longitudinal, large-scale and multi-modal studies to examine potential biomarkers and better understand their functions across various stages of reproduction.

摘要

背景

虽然生物标志物在其他医学领域被广泛应用,但精神病学领域尚未引入可靠的生物学诊断工具。女性生殖转变为研究精神科生物标志物提供了一个独特的机会窗口。月经、怀孕、分娩和围绝经期期间的激素变化可能对易感个体的心理健康产生显著影响,从而有助于识别与这些波动相关的独特生物标志物。

目的

本综述整合了有关潜在生物标志物的现有证据,重点关注围产期抑郁、焦虑和强迫症、产后精神病、经前烦躁障碍和围绝经期抑郁的近期人体研究。

方法

我们通过使用PubMed检索自2010年以来关于上述六种病症的英文文章,并添加“生物标志物”、“表观遗传学”、“神经活性类固醇”、“免疫”、“炎症”和“神经影像学”等关键词,来确定纳入本叙述性综述的潜在文章。

结果

在表观遗传学、神经活性类固醇、免疫功能和神经影像学领域,有大量关于生殖精神障碍潜在生物标志物的已发表证据。这一系列研究在推进生物标志物开发、揭示疾病机制以及改善诊断和治疗策略方面具有巨大潜力,但目前尚无任何生殖精神障碍的临床可用生物标志物处于商业开发阶段。

结论

迫切需要开展纵向、大规模和多模式研究,以检验潜在生物标志物,并更好地了解它们在生殖各阶段的功能。

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