Infectious Diseases and Mental Health
Infectious Diseases and Mental Health
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DOI：
10.1159/000365542
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发表时间：
2015-01-01
期刊：
影响因子：
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通讯作者：
Mueller, Norbert
中科院分区：
文献类型：
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作者：
Mueller, Norbert
现代精神病分类的创始人埃米尔·克雷佩林（Emil Kraepelin）和诺贝尔奖获得者朱利叶斯·瓦格纳·冯·尧雷格（Julius von Jauregg）强调了感染和免疫系统在精神疾病中的作用。众所周知，感染可引发各种精神综合征并影响精神障碍的病程。病毒感染期间的精神症状，通常表现为脑炎或脑膜炎，通常被诊断为由于一般医疗条件引起的精神障碍。另一方面，一个不断扩大的研究领域支持了这样一种观点，即感染和免疫系统的激活可能在精神分裂症或重度抑郁症等重大精神疾病中发挥致病作用。在其他精神综合征中，如图雷特综合征，也涉及炎症-部分基于感染。对于这种轻微的闷烧炎症过程，“轻度（慢性）脑炎”的概念被开发出来。在这一章中，研究结果相关的免疫激活和炎症精神分裂症，抑郁症和抽动秽语综合征的例子，这一概念进行了说明。此外，精神分裂症和抑郁症的随机临床试验结果令人鼓舞的抗炎治疗在这些精神疾病的好处进行了讨论，作为精神疾病的免疫调节治疗方法的例子。进一步的免疫疗法用于抽动秽语综合征或与链球菌相关的儿科自身免疫性疾病，作为这种治疗方法的进一步例子。(C)2015 S. Karger AG，巴塞尔
Emil Kraepelin, the founder of modern psychiatric classification, and the Nobel laureate Julius Wagner von Jauregg highlighted the role of infections and the immune system in psychiatric disorders. It is well known that infections can trigger various psychiatric syndromes and influence the course of psychiatric disorders. Psychiatric symptoms during virulent infections, often presenting as encephalitis or meningitis, normally are diagnosed as mental disorders due to a general medical condition. On the other hand, an expanding research field underpins the view that infections and activation of the immune system may play a causative role in major psychiatric disorders such as schizophrenia or major depression. Also in other psychiatric syndromes, such as Tourette's syndrome, inflammation-partially based on infections - is involved. For this mild smoldering inflammatory process, the 'mild (chronic) encephalitis' concept was developed. In this chapter, findings related to immune activation and inflammation in schizophrenia, major depression and Tourette's syndromes as examples for this concept are described. Moreover, encouraging results from randomized clinical trials in schizophrenia and major depression showing a benefit of anti-inflammatory therapy in these psychiatric disorders are discussed as examples for immunomodulating treatment approaches in psychiatric disorders. Further immunotherapies used in Tourette's syndrome or pediatric autoimmune disorders associated with streptococci are highlighted as further examples for such a therapeutic approach. (C) 2015 S. Karger AG, Basel