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Prog Neuropsychopharmacol Biol Psychiatry:伴有胃肠道症状的重度抑郁症患者的脑结构发生改变

2021-06-26 MedSci原创 MedSci原创

MDD患者的胃肠道症状往往经历更严重的抑郁症症状。此外,伴有胃肠道症状的MDD患者双侧丘脑GMV和GMD较大,双侧颞上回和双侧岛叶GMV较小。

据估计,全世界有3.32亿人患有抑郁症。2015年,抑郁症被列为全球非致命健康负担的主要催化剂。重度抑郁障碍(MDD)的诊断对象是患有2周以上抑郁症状的患者,这些症状可能表现为情绪、认知和/或躯体症状。大约69%的MDD患者会出现躯体症状,包括食欲紊乱、消化不良、失眠、疲劳、头痛和无法解释的呼吸短促。正如对14个国家的15个初级卫生保健中心的研究所表明的那样,患者通常因躯体症状而非抑郁症状寻求医疗救助。同一项研究表明,45%至90%的抑郁症患者主要因躯体症状而就医。此外,MDD患者躯体症状的存在与抑郁症的严重程度和不良预后之间似乎存在相关性。研究同样表明,躯体症状与MDD患者更严重的疾病、治疗失败或治疗反应不足以及更长的患病时间有关。一项针对MDD患者的前瞻性观察研究显示,抑郁的严重程度与躯体症状的存在呈正相关。此外,这项研究表明,与没有严重躯体症状的患者相比,患有严重躯体症状的患者的缓解率仅为后者的一半。有关躯体症状的投诉往往是寻求医疗照顾的动机因素。通常,MDD患者如果出现失眠或胃痛等躯体症状,通常会去综合医院就诊,而不是寻求专家的评估。因此,他们的抑郁症仍然没有得到诊断,或者在诊

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time=2021-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556527, encodeId=b9f1155652eba, content=<a href='/topic/show?id=ab7e85001cf' target=_blank style='color:#2F92EE;'>#脑结构#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85001, encryptionId=ab7e85001cf, topicName=脑结构)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f3114785325, createdName=wmr116, createdTime=Sun Jun 27 16:51:36 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1908636, encodeId=861e19086361a, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Wed Feb 02 10:51:36 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988612, encodeId=d2031988612fc, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, 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topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Sat Nov 13 01:51:36 CST 2021, time=2021-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1787721, encodeId=175a1e87721a3, content=<a href='/topic/show?id=fa03141591e' target=_blank style='color:#2F92EE;'>#Pharm#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14159, encryptionId=fa03141591e, topicName=Pharm)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Jul 15 10:51:36 CST 2021, time=2021-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1996404, encodeId=09e619964040b, content=<a href='/topic/show?id=ed881120ec8' target=_blank style='color:#2F92EE;'>#MAC#</a>, 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content=<a href='/topic/show?id=64f5343e2f' target=_blank style='color:#2F92EE;'>#Biol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3437, encryptionId=64f5343e2f, topicName=Biol)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=446937890434, createdName=12498ebem31暂无昵称, createdTime=Sat Sep 25 14:51:36 CST 2021, time=2021-09-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346355, encodeId=423f1346355b0, content=<a href='/topic/show?id=339e8332035' target=_blank style='color:#2F92EE;'>#胃肠道#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83320, encryptionId=339e8332035, topicName=胃肠道)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e03212, createdName=liao1619, createdTime=Sun Jun 27 16:51:36 CST 2021, time=2021-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556527, encodeId=b9f1155652eba, content=<a href='/topic/show?id=ab7e85001cf' target=_blank style='color:#2F92EE;'>#脑结构#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85001, encryptionId=ab7e85001cf, topicName=脑结构)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f3114785325, createdName=wmr116, createdTime=Sun Jun 27 16:51:36 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
    2021-07-15 jj000001
  6. 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time=2021-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556527, encodeId=b9f1155652eba, content=<a href='/topic/show?id=ab7e85001cf' target=_blank style='color:#2F92EE;'>#脑结构#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85001, encryptionId=ab7e85001cf, topicName=脑结构)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f3114785325, createdName=wmr116, createdTime=Sun Jun 27 16:51:36 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
    2022-02-21 yb6560
  7. 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time=2021-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556527, encodeId=b9f1155652eba, content=<a href='/topic/show?id=ab7e85001cf' target=_blank style='color:#2F92EE;'>#脑结构#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85001, encryptionId=ab7e85001cf, topicName=脑结构)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f3114785325, createdName=wmr116, createdTime=Sun Jun 27 16:51:36 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
    2021-09-27 sunylz
  8. 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time=2021-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1556527, encodeId=b9f1155652eba, content=<a href='/topic/show?id=ab7e85001cf' target=_blank style='color:#2F92EE;'>#脑结构#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85001, encryptionId=ab7e85001cf, topicName=脑结构)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4f3114785325, createdName=wmr116, createdTime=Sun Jun 27 16:51:36 CST 2021, time=2021-06-27, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=1908636, encodeId=861e19086361a, content=<a href='/topic/show?id=a8d0141605e' target=_blank style='color:#2F92EE;'>#pharma#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14160, encryptionId=a8d0141605e, topicName=pharma)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f634250, createdName=chentianping, createdTime=Wed Feb 02 10:51:36 CST 2022, time=2022-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1988612, encodeId=d2031988612fc, content=<a href='/topic/show?id=1fe2549e72e' target=_blank style='color:#2F92EE;'>#抑郁症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54977, encryptionId=1fe2549e72e, topicName=抑郁症患者)], attachment=null, authenticateStatus=null, createdAvatar=, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11207, encryptionId=ed881120ec8, topicName=MAC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Mon Feb 21 10:51:36 CST 2022, time=2022-02-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1919274, encodeId=448019192e425, content=<a href='/topic/show?id=4f26341994' target=_blank style='color:#2F92EE;'>#Bio#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3419, encryptionId=4f26341994, topicName=Bio)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Mon Sep 27 13:51:36 CST 2021, time=2021-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1767853, encodeId=c19d1e67853b1, 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  10. 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    2021-06-27 wmr116

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