双相障碍伴混合特征的病理机制研究进展  

Research progress on the pathological mechanism of bipolar disorder with mixed features

作　　者：周霓 汪作为[2] 陈依明 洪武[1,3,4] ZHOU Ni;WANG Zuowei;CHEN Yiming;HONG Wu(Shanghai Mental Health Center,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心,上海200030 [2]上海市虹口区精神卫生中心 [3]上海市重性精神病重点实验室 [4]上海交通大学中国医院发展研究院心理健康管理研究所

出　　处：《中国神经精神疾病杂志》2024年第10期614-618,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：上海市“科技创新行动计划”医学创新研究专项(编号:21Y11905600);上海市“科技创新行动计划”自然科学基金项目(编号:21ZR1455100);上海交通大学医学院科技创新项目(人文社科类)(编号:WK2017);上海市医学重点专科建设计划(ZK2019A06);上海市精神卫生中心研究型医生项目(编号:2021-YJXYS-06);上海市卫生健康系统重点学科建设项目(编号:2024ZDXK0013)。

摘　　要：临床上双相障碍伴混合特征广泛存在,患者自杀风险较高,治疗效果不理想,预后较差,且常伴有严重的心理社会功能损害。目前相关病理机制研究认为双相障碍伴混合特征的发生机制包括:神经递质失衡导致情绪调节异常;下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal,HPA)轴功能失调引发过度应激反应;昼夜节律紊乱影响睡眠模式;大脑皮质和边缘系统等功能连接异常;行为、认知、情绪、睡眠4个维度上独立和多向变化。未来的研究需进一步整合神经生物学、影像学、遗传学等多学科领域的成果,以期为双相障碍伴混合特征的诊治提供更加精准的靶点。Bipolar disorder with mixed features is currently a prevalent clinical phenomenon,with patients exhibiting a heightened risk of suicidal behaviour,suboptimal therapeutic outcomes,poor prognostic indicators and frequently accompanied by significant impairment in psychosocial functioning.The current body of research on the pathological mechanisms of bipolar disorder with mixed features has proposed several mechanisms including neurotransmitter imbalance leading to abnormal emotion regulation,hypothalamic-pituitary-adrenal(HPA)dysfunction triggering an excessive stress response,circadian rhythm disorder affecting the sleep pattern,abnormal functional connectivity of the cerebral cortex and limbic system,independent and multidirectional changes in four dimensions,such as behaviour,cognition,mood,and sleep.Further studies are required to integrate the results of neurobiology,imaging,genetics and other multidisciplinary fields in order to provide more precise targets for the diagnosis and treatment of bipolar disorder with mixed features.

关 键 词：双相障碍 混合特征 病理机制 神经递质失衡 神经内分泌 昼夜节律紊乱 神经影像学 

分 类 号：R749.4[医药卫生—神经病学与精神病学]