抑郁症的抗炎诊疗策略

Anti-inflammatory strategies for major depressive disorder

抑郁症是一类现代社会常见、流行的精神障碍,其诊断常基于症状学评估,治疗方式以药物为主,心理及物理治疗等为辅。鉴于目前单胺能经典抗抑郁药的临床疗效不够理想,相关机制与防治研究仍在推进。近年研究表明,炎症细胞因子通过改变神经传递、神经可塑性和神经内分泌功能等途径介导抑郁症的发生、发展及转归;抗炎疗法或可作为增强抗抑郁药物疗效的新选项。该文整合国内外应用抗炎药物治疗抑郁症及躯体疾病合并抑郁症状的临床研究,分析抗炎疗法用于抑郁症诊疗的具体路径,提出针对抑郁症诊断分类、个性化治疗和预后评估的新策略。

Major depressive disorder(depression) is currently a common,frequent,and prevalent mental disorder.The diagnosis of depression is usually based on symptomatic assessment,while treatment mainly involves medication combined with psychological and physical therapy.Given that the clinical efficacy of classic monoaminergic antidepressants is unsatisfactory,researches on related mechanisms as well as prevention and treatment of depression are still burgeoning.Recent studies have shown that cytokines may mediate the occurrence,development,and prognosis of depression by altering pathways including neurotransmission,neural plasticity,and neuroendocrine function,suggesting anti-inflammatory therapy as a potential novel approach to enhancing the efficacy of classical antidepressants.This review integrates global clinical researches on the application of antiinflammatory drugs in the treatment of depression and somatic diseases with depressive symptoms,analyzes the specific procedures for applying anti-inflammatory therapy for depression,and proposes a new strategy for the diagnosis,classification,personalized treatment,and prognosis evaluation of depression.