Neurobiology of maternal mental illness.
Neurobiology of maternal mental illness.
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DOI：
10.1016/b978-0-444-64239-4.00005-9
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发表时间：
2020-01-01
影响因子：
--
通讯作者：
Monk, Catherine
中科院分区：
文献类型：
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作者：
Maguire, Jamie;McCormack, Clare;Monk, Catherine
本章概述了目前的研究发现，开始揭示母亲精神疾病的神经生物学。结果是根据标准诊断类别(特别是围产期抑郁、围产期焦虑和强迫症、产后精神病和双相情感障碍、创伤和创伤后应激障碍)来描述的，但我们的目标是将这种方法放在背景下，引入精神病学研究的分类模型，研究领域标准，在基础和临床翻译领域获得吸引力。我们首先回顾了一个新的研究领域，怀孕和产后大脑的神经可塑性，因为这里的工作对于理解精神障碍的病理生理学具有相关性，并可能提供与产后抑郁背景下父母教养方式受损相关的大脑功能变化的线索。我们接下来提供怀孕期间和产后期间神经内分泌和免疫变化的背景信息，因为这些系统的变化与围产期妇女精神疾病的潜在神经生物学显著相关。我们对孕妇和产后妇女的主要精神疾病的讨论包括神经内分泌变化、神经炎症和神经递质变化，以及电路功能障碍。总体而言，在确定与产妇精神疾病有关的神经生物学(和相关系统)变异方面取得了显著进展；然而，很明显，按照标准诊断系统分类，这些都是异质性障碍，同一疾病的神经生物学变异存在个体差异。
This chapter provides an overview of current research discoveries beginning to uncover the neurobiology of maternal mental illness. Results are described according to standard diagnostic categories (specifically, perinatal depression, perinatal anxiety and OCD, postpartum psychosis and bipolar disorder, and trauma and posttraumatic stress disorder), yet we aim to put this approach in context with the introduction of a classification model for psychiatric research, the research domain criteria, gaining traction in basic and clinical translational fields. We first review a new area of study, the neuroplasticity of the pregnant and postpartum brain, as work here has relevance for understanding the pathophysiology of mental disorders and may provide clues to changes in brain functioning that are related to compromised parenting in the context of postpartum depression. We next provide background information on neuroendocrine and immune changes during pregnancy and, to a lesser extent, the postpartum period, as alterations in these systems are significantly implicated in underlying neurobiology of mental illness for peripartum women. Our discussion of the major mental illnesses for pregnant and postpartum women includes neuroendocrine changes, neuroinflammation, and neurotransmitter alterations, as well as circuit dysfunction. Overall, remarkable progress has been made in identifying variations in neurobiology (and related systems) involved in maternal mental illness; yet, it is clear that, as classified with standard diagnostic systems, these are heterogeneous disorders and there is individual variability in the alterations in neurobiology for the same illness.