A reproductive subtype of depression: conceptualizing models and moving toward etiology.
A reproductive subtype of depression: conceptualizing models and moving toward etiology.
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DOI：
10.1080/10673220902899706
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发表时间：
2009
影响因子：
3.8
通讯作者：
Joffe H
中科院分区：
文献类型：
--
作者：
Payne JL;Palmer JT;Joffe H
众所周知，女性患重度抑郁症的终生风险是男性的两倍，在初潮和绝经之间的生育期尤其高。一部分育龄妇女会经历由荷尔蒙波动引发的抑郁发作。这种“生殖抑郁症”包括抑郁症发作，特别是发生在妇女的经前，产后和围月经期。这些抑郁症的生殖亚型可以被概念化为对大脑中激素波动影响的特定生物反应。不同类型的生殖抑郁症彼此相关，具有独特的风险因素，与非生殖抑郁症发作不同，并对激素和非激素干预措施作出反应。本综述使用PubMed检索相关文献，讨论生殖抑郁症作为重度抑郁症的一种特定亚型的临床、动物和遗传证据。独特的治疗方案，如激素干预，也进行了讨论，并探讨了关于生殖抑郁症的基础生物学的假设，包括雌激素系统和雌激素之间的相互作用，以及对神经类固醇的具体影响。本综述将提供证据支持生殖性抑郁症作为一个独特的临床实体，具有特定的治疗方法和独特的生物学，是独立于非生殖性抑郁症。
The lifetime risk for major depression in women is well known to be twice the risk in men and is especially high during the reproductive years between menarche and menopause. A subset of reproductive-age women experience depressive episodes that are triggered by hormonal fluctuations. Such “reproductive depressions” involve episodes of depression that occur specifically during the premenstrual, postpartum, and perimenopausal phases in women. These reproductive subtypes of depression can be conceptualized as a specific biological response to the effects of hormonal fluctuations in the brain. The different types of reproductive depressions are associated with each other, have unique risk factors that are distinct from nonreproductive depression episodes, and respond to both hormonal and nonhormonal interventions. This review uses a PubMed search of relevant literature to discuss clinical, animal, and genetic evidence for reproductive depression as a specific subtype of major depression. Unique treatment options, such as hormonal interventions, are also discussed, and hypotheses regarding the underlying biology of reproductive depression—including interactions between the serotonergic system and estrogen, as well as specific effects on neurosteroids—are explored. This review will provide evidence supporting reproductive depression as a distinct clinical entity with specific treatment approaches and a unique biology that is separate from nonreproductive depression.
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