Gastrointestinal distress to Serotonergic challenge: A risk marker for emotional disorder?
Gastrointestinal distress to Serotonergic challenge: A risk marker for emotional disorder?
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DOI：
10.1097/00004583-200310000-00013
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发表时间：
2003-10-01
影响因子：
13.3
通讯作者：
Ryan, ND
中科院分区：
文献类型：
--
作者：
Campo, JV;Dahl, RE;Ryan, ND
目的：血清素是肠道感觉和运动的重要介质。作者的目的是确定无意的胃肠道（GI）对血清素能挑战的困扰是否预示着暴露儿童未来的严重抑郁和/或焦虑障碍。方法：对119名无精神障碍的青春期前儿童进行l -5-羟色氨酸治疗，作为一项心理生物学队列研究的一部分，该研究最初旨在检查家族性情绪障碍负荷作为兴趣暴露。随访时间为90.3 +/- 29.2个月，平均评估间隔为16.6 +/- 6.2个月，采用标准化精神病学访谈对受试者进行纵向随访，以确定新发情绪和焦虑障碍。在5 -羟色胺能刺激期间的一个亚组中有GI窘迫的报告，这促使作者检查GI窘迫对输注的影响，并使用重度抑郁症和/或焦虑症作为研究结果进行生存分析。结果：23名受试者经历了5 -羟色胺能挑战的胃肠道痛苦，其中7人（30.4%）在随访期间出现情绪障碍，而96名非痛苦受试者中有12人（10.4%）出现情绪障碍。即使在控制了精神疾病家族史之后，痛苦组出现严重抑郁和/或焦虑的风险也显著增加（p = 0.026）。结论：儿童期5 -羟色胺能挑战导致的胃肠道窘迫与随后的重度抑郁和/或焦虑障碍的高风险相关。研究血清素能神经传递可能有助于我们理解功能性胃肠道症状与情绪症状和障碍之间的非随机关联。
Objective: Serotonin is an important mediator of gut sensation and motility. The authors' aim was to determine whether inadvertent gastrointestinal (GI) distress to serotonergic challenge predicted future major depressive and/or anxiety disorders in exposed children. Method: L-5-hydroxytryptophan was administered to 119 prepubertal children free of psychiatric disorder as part of a psychobiological cohort study initially designed to examine familial loading for mood disorder as the exposure of interest. Subjects were followed longitudinally with standardized psychiatric interviews to identify new-onset mood and anxiety disorders over 90.3 +/- 29.2 months, with the average assessment interval being 16.6 +/- 6.2 months. Reports of GI distress in a subgroup during serotonergic challenge led the authors to examine GI distress to infusion as an exposure post hoc and to perform survival analysis using major depressive and/or anxiety disorders as the outcomes of interest. Results: GI distress to serotonergic challenge was experienced by 23 subjects, with 7 (30.4%) developing an emotional disorder during follow-up in comparison to 12 (10.4%) of 96 nondistressed subjects. The distressed group was at significantly greater risk of subsequent major depression and/or anxiety (p = .026), even after controlling for family history of psychiatric disorder. Conclusions: GI distress to serotonergic challenge in childhood is associated with heightened risk for subsequent major depressive and/or anxiety disorders. Studies of serotonergic neurotransmission may aid our understanding of nonrandom associations between functional GI symptoms and emotional symptoms and disorders.