Mc Ivor R J, Davies R A, Wieck A, Marks M N, Brown N, Campbell I C, Checkley S A, Kumar R
Dept. of Psychiatry, Institute of Psychiatry, London, UK.
J Affect Disord. 1996 Oct 14;40(3):131-6. doi: 10.1016/0165-0327(96)00049-3.
We have examined the responsiveness of dopamine sensitive neurones in the postpartum period in woman with a history of major depression who are at high risk of experiencing a recurrence of illness in the postpartum period. Fourteen women were assessed at 36 weeks of pregnancy and during the 3 months following delivery, using the Schedule for Affective Disorders and Schizophrenia, including its change version. They were not depressed at initial assessment. Five of the 14 women went on to experience a postpartum relapse (2 major depressive disorder, 2 generalised anxiety disorder, 1 panic disorder). On the fourth day postpartum, i.e., before relapse, the growth hormone response to the dopamine agonist apomorphine was measured as an index of the functional state of hypothalamic dopamine D2 receptors. Women who subsequently relapsed had a significantly greater growth hormone response to apomorphine than those who remained well. This was particularly marked in women with anxiety/panic. The development of increased sensitivity of hypothalamic dopamine D2 receptors in the postpartum period appears to predict the onset of depressive and anxiety disorders.
我们研究了有重度抑郁症病史且在产后有高复发风险的女性产后多巴胺敏感神经元的反应性。14名女性在妊娠36周时以及分娩后的3个月内接受评估，使用情感障碍和精神分裂症检查表，包括其修订版。她们在初次评估时未患抑郁症。14名女性中有5名经历了产后复发（2例重度抑郁症、2例广泛性焦虑症、1例恐慌症）。在产后第四天，即复发前，测量了生长激素对多巴胺激动剂阿扑吗啡的反应，作为下丘脑多巴胺D2受体功能状态的指标。随后复发的女性对阿扑吗啡的生长激素反应明显大于未复发的女性。这在患有焦虑症/恐慌症的女性中尤为明显。产后下丘脑多巴胺D2受体敏感性增加似乎预示着抑郁和焦虑症的发作。
