Stefos G, Staner L, Kerkhofs M, Hubain P, Mendlewicz J, Linkowski P
Department of Psychiatry, CHU Saint-Pierre Brussels, Belgium.
Biol Psychiatry. 1998 Dec 15;44(12):1314-20. doi: 10.1016/s0006-3223(98)00009-2.
Previous reports suggest that the clinical dichotomy separating psychotic and nonpsychotic depression corresponds to different neurobiological profiles. The aim of the present study is to further investigate the psychobiological correlates of these two particular depressive subtypes.
Thyroid-stimulating hormone response to thyrotropin-releasing hormone postdexamethasone cortisol levels, and electroencephalgraphic sleep characteristics of 44 psychotic major depressive patients were compared to those of 44 nonpsychotic depressives matched for age, gender, and polarity.
Some biological disturbances usually associated with depression (increased wakefulness, diminished rapid eye movement latency, hypercortisolism, blunted thyroid-stimulating hormone response to thyrotropin-releasing hormone stimulation) seemed to be significantly more pronounced in the psychotic depressed group as a reflection of greater illness severity; however, shortened REM latency was not influenced by severity and seemed to be more specifically related to the co-occurrence of psychotic and depressive symptoms.
Our data provide further support for the validity of the clinical dichotomy separating psychotic and nonpsychotic major depression independently of severity.
先前的报告表明,区分精神病性抑郁和非精神病性抑郁的临床二分法对应于不同的神经生物学特征。本研究的目的是进一步探究这两种特定抑郁亚型的心理生物学相关性。
将44例精神病性重度抑郁患者的促甲状腺激素对促甲状腺素释放激素的反应、地塞米松后皮质醇水平以及脑电图睡眠特征与44例在年龄、性别和极性方面相匹配的非精神病性抑郁患者进行比较。
一些通常与抑郁相关的生物学紊乱(觉醒增加、快速眼动潜伏期缩短、高皮质醇血症、促甲状腺激素对促甲状腺素释放激素刺激的反应迟钝)在精神病性抑郁组中似乎更为明显,这反映了病情更严重;然而,快速眼动潜伏期缩短不受病情严重程度影响,似乎更具体地与精神病性症状和抑郁症状的共现有关。
我们的数据进一步支持了区分精神病性和非精神病性重度抑郁的临床二分法的有效性,且该二分法与病情严重程度无关。