抑郁症基础 讲座.pptx

Depression(majordepressivedisorder)山西医科大学生理学系李建国抑郁症（抑郁障碍）

Depressionisacommonmentaldisorder.Anestimated350millionpeople(5%)ofallagessufferfromdepression.Lifetimepopulationprevalenceisashighas20%.Depressionisthesecond-leadingcauseofdisability,andisamajorcontributortotheoverallglobalburdenofdisease.Morewomenareaffectedbydepressionthanmen.Atitsworst,depressioncanleadtosuicide.mentaldisorder精神障碍2

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(PLOSmedicine,2013)depressionworldmap20104

(NationalInstituteofMentalHealth,2002)Depressionoftenco-occurswithotherillnessesCancer:25%Strokes:27%Heartattacks:33%HIV:33%ParkinsonsDisease:50%Substanceuse:27%5

61.Theneurobiologyofdepression3.Treatmentfordepression2.Diagnosticcriteriafordepression4.PreclinicalresearchDiagnosticcriteria诊断标准

7Diathesis:GeneticdiathesisEarlylifeexperience30-40%Stress:InternaleventExternaleventAmajoradverselifeeventAnaccumulationofchronicminorstresses1.TheneurobiologyofdepressionDiathesis体质

8stressIfstressisuncontrollablevPFCAMG↓Nacc↑AMG↑Nacc↓Ifstressiscontrollable1)Onsetofdepression(failuretocope)1.Theneurobiologyofdepression

9aself-sustainingviciouscircleinwhichattentiontonegativeinformationpromotesnegativethinkingadysregulatedsubcorticalnetworkandHPAaxisstress-inducedneurotoxicity.1.Theneurobiologyofdepression1)Onsetofdepression(failuretocope)2)Maintenanceofdepression(rumination)Rumination沉思viciouscircle恶性循环

10prefrontalcortex(PFC前额叶皮层)hippocampus(HYP海马)amygdala(AMG杏仁核)nucleusaccumbens(Nacc伏隔核)ventraltegmentalarea(VTA腹侧被盖区)Dorsalraphenuclei(DR/RN中缝核)hypothalamus(HP下丘脑)1.Theneurobiologyofdepression

11ventromedialprefrontalcortex(vmPFC),dorsolateralprefrontalcortex(dlPFC),hypothalamus(PVN),ant