From the neurobiological basis of comorbid alcohol dependence and depression to psychological treatment strategies: bridging the knowledge gap

从共病酒精依赖和抑郁症的神经生物学基础到心理治疗策略：弥合知识差距

• 批准号: 298883686
• 负责人: Professor Dr. Peter Kirsch
• 金额: --
• 依托单位: Abteilung Klinische Psychologie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2020-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/298883686?language=en
• 关键词: neurobiological; basis; comorbid; alcohol; dependence

The prevalence of affective disorders in alcohol addiction is estimated to around 23% and the presence of alcohol dependence increases the risk for depression by a factor of almost 5. Suffering from a comorbid depression substantially deteriorates the prognosis of alcohol dependent patients. Despite these tremendous implications for prevention, treatment and disease progression, the mechanisms underlying this comorbidity are not well understood. Although there is significant knowledge of the environmental and neurobiological factors involved in depression and alcohol addiction, only a few studies have tried to translate these empirical findings for a better understanding and treatment of comorbid patients. Furthermore, some of the neurobiological signatures of addiction and depression show even contrary characteristics. While alcohol patients seem to have increased brain reward system responsivity, depressed patients show a reduced sensitivity of the system. While depression is characterized by increased default mode network connectivity, reduced connectivity has been described for alcohol addiction. The proposed project aims to integrate previous research about the reward circuit and brain connectivity associated with alcohol dependence and depression to achieve a better understanding of neural mechanisms characterizing their comorbidity. By means of diverse experimental paradigms allowing a comprehensive characterization of reward and default mode network activity and connectivity and by comparing depressed and addicted patients with comorbid patients, we are planning to identify distinct and common mechanisms underlying the comorbidity of alcohol addiction and depression. In addition, the neurobiological results will be used to test whether a brief psychotherapeutic intervention program is satiable to positively influence the identified neural pathomechanisms.

据估计，酒精成瘾中情感障碍的患病率约为23%，酒精依赖的存在使患抑郁症的风险增加了近5倍。患有共病性抑郁症会严重恶化酒精依赖患者的预后。尽管这些对预防、治疗和疾病进展的巨大影响，但这种合并症的潜在机制尚不清楚。尽管对抑郁和酒精成瘾的环境和神经生物学因素有重要的了解，但只有少数研究试图将这些经验发现转化为更好地理解和治疗合并症患者。此外，成瘾和抑郁的一些神经生物学特征甚至显示出相反的特征。虽然酗酒的患者似乎有增加大脑奖励系统的反应，抑郁症患者表现出系统的敏感性降低。虽然抑郁症的特点是默认模式网络连接增加，但酒精成瘾的连接减少。该项目旨在整合先前关于酒精依赖和抑郁症相关的奖赏回路和大脑连接的研究，以更好地理解表征其共病的神经机制。通过多种实验范式，对奖励和默认模式网络活动和连通性进行全面表征，并将抑郁和成瘾患者与共病患者进行比较，我们计划确定酒精成瘾和抑郁共病的独特和共同机制。此外，神经生物学结果将用于测试是否一个简短的心理治疗干预方案是满意的积极影响确定的神经病理机制。