Biological underpinnings of the commonalities in depression, somatization, and Chronic Fatigue Syndrome
Biological underpinnings of the commonalities in depression, somatization, and Chronic Fatigue Syndrome
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DOI：
10.1016/j.mehy.2012.02.023
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发表时间：
2012-06-01
影响因子：
4.7
通讯作者：
Berk, Michael
中科院分区：
文献类型：
--
作者：
Anderson, George;Maes, Michael;Berk, Michael
背景：躯体化是一种以医学上无法解释的功能性或心身性症状为特征的多躯体形式障碍。相似的躯体症状是抑郁症和肌痛性脑脊髓炎/慢性疲劳综合征（ME/CFS）的关键组成部分。我们使用术语“physiosomatic”来描述这些symptoms.Results：炎症，细胞介导的免疫（CMI）激活和色氨酸分解代谢物（TRYCAT）途径的改变与抑郁症，ME/CFS和/或躯体化的生理-躯体症状。促炎细胞因子，色氨酸和畸变TRYCATs可能会导致生理-躯体症状，如疲劳，自主神经症状，痛觉过敏和躯体presentation.Conclusions：数据表明协调和相互作用的生物途径驱动这三种疾病的生理-躯体症状的发生，给出了生物学验证的“途径表型”。这些数据具有深远的影响DSM-IV诊断概念化的躯体化（和ME/CFS），这表明存在一个新兴的有机解释。未来的研究应该集中在免疫调节和神经元活动协调的作用，并通过更大的数据集，最终创建新的，生物学验证的分类规则。这些数据对利用这些见解开发新疗法具有影响，支持了心理治疗在心身表现中的作用。(C)2012爱思唯尔有限公司保留所有权利。
Background: Somatization is a multisomatoform disorder characterized by medically unexplained, functional or psychosomatic symptoms. Similar somatic symptoms are key components of depression and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).Methods: This paper reviews the evidence that such symptoms are organically based. We use the term "physio-somatic" to describe these symptoms.Results: Inflammation, cell-mediated immune (CMI) activation and alterations in the tryptophan catabolite (TRYCAT) pathway are associated with the physio-somatic symptoms of depression, ME/CFS and/or somatization. Proinflammatory cytokines, decreased tryptophan and aberrations in TRYCATs may cause physio-somatic symptoms, such as fatigue, autonomic symptoms, hyperalgesia and somatic presentations.Conclusions: The data suggest co-ordinated and interacting biological pathways driving the occurrence of physio-somatic symptoms across these three disorders, giving a biologically validated "pathway phenotype". These data have far-reaching implications for DSM-IV diagnostic conceptualizations of somatization (and ME/CFS) suggesting the presence of an emerging organic explanation. Future research should focus on the role of immune regulation, and co-ordination, of neuronal activity and, through larger data sets, ultimately creating new, biologically validated classification rules. These data have implications for the development of novel therapies utilizing these insights, buttressing the role of psychotherapy in psychosomatic presentations. (C) 2012 Elsevier Ltd. All rights reserved.