经前期烦躁障碍发病机制及治疗研究进展

Pathogenesis and treatment of premenstrual dysphoric disorder:research progress

经前期烦躁障碍(PMDD)在美国《精神障碍诊断和统计手册》第5版(DSM-5)中被列为心境障碍的一个类型,除了呈现情绪低落、烦躁等抑郁症状外,还可伴随躯体症状,具有经前期发作的特点。PMDD的病因和发病机制尚未明确,与其发病可能有关的因素包括雌性激素的波动、神经类固醇激素作用减弱、免疫激活和炎症反应、有关脑区(杏仁核、前额叶等)功能活动异常、心理社会因素等。因发病机制不明,PMDD尚未有根治性治疗方法,目前主要通过药物治疗(如抗抑郁药与口服避孕药)、心理治疗、中医药治疗(如中药、针灸)等方面缓解患者症状。

Premenstrual dysphoric disorder(PMDD)is diagnosed as a type of mood disorder in the Diagnostic and Statistical Manual of Mental Disorders 5;edition(DSM-5).In addition to depressive symptoms,PMDD can be accompanied by somatic symptoms and is characterized by cyclicity(premenstrual).The etiology and pathogenesis of PMDD are not clear,probably involving the fluctuation of estrogen,the weakened role of neurosteroids hormones,immune activation and inflammatory response,the abnormal functional activities of some brain areas(such as amygdala,prefrontal cortex),psychosocial factors,etc.There is no radical treatment for PMDD due to the unknown pathogenesis.Treatments including drugs(such as antidepressants,oral contraceptives),psychotherapy,and complementary medicines(such as traditional Chinese medicine,acupuncture)are used to relieve patients’symptoms.