PMS/PMDD与抑郁症共病探讨
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摘要
随着人类疾病谱的突变和社会变迁,抑郁症、经前期综合征等精神情绪类疾病高发,中医称之为情志病。此类疾病对患者躯体及心理造成严重的负面影响,表现为诸多情感障碍症状,病程日久,影响人际关系,降低生活、工作质量,影响严重者会有轻生念头,甚者造成家庭悲剧。临床大数据研究发现:具有焦虑、抑郁特质的个体易患经前期综合征,经前期综合征中医辨证分型趋于焦虑型和抑郁型两类,而抑郁症共病焦虑障碍亦是精神科临床最常见的共病形式。作为高发疾病的抑郁症和经前期综合征是否存在某种共病机制?二者易感特质存在何种联系?理清相关关系对于进一步的药物研发、临床防治迫在眉睫。
With the sudden changes of human disease spectrum and social changes,depression,premenstrual syndrome and other emotional diseases,are known as Chinese medicine emotional diseases. Such diseases negatively impact the patients' physical and psychological conditions,resulting in many symptoms of emotional disorders,duration of disease,interpersonal relationships,reducing life and work quality and expecially the patients would have the idea of suicide. Clinical statistics found that individuals who have anxiety and depression characteristics are susceptible to suffer premenstrual syndrome,and the syndrome differentiation includes anxiety type and depression type. Depression complicated with anxiety disorder is also the most common psychiatric comorbidity. Is there a co-morbid mechanism for depression and premenstrual syndrome as a high incidence of disease? What is the relationship between the two susceptible traits? Clarifying the relationship for further drug research and development,clinical prevention and control is imminent.
With the sudden changes of human disease spectrum and social changes,depression,premenstrual syndrome and other emotional diseases,are known as Chinese medicine emotional diseases. Such diseases negatively impact the patients' physical and psychological conditions,resulting in many symptoms of emotional disorders,duration of disease,interpersonal relationships,reducing life and work quality and expecially the patients would have the idea of suicide. Clinical statistics found that individuals who have anxiety and depression characteristics are susceptible to suffer premenstrual syndrome,and the syndrome differentiation includes anxiety type and depression type. Depression complicated with anxiety disorder is also the most common psychiatric comorbidity. Is there a co-morbid mechanism for depression and premenstrual syndrome as a high incidence of disease? What is the relationship between the two susceptible traits? Clarifying the relationship for further drug research and development,clinical prevention and control is imminent.
引文
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[44]邹志勇,马军,王海俊,等.中国7-17岁青春期女生月经初潮较早与血压水平的关系[J].中华预防医学杂志,2013,47(8):726-730.
[45]Drosdzol A,Nowosielski K,Skrzypulec V,et al.Premenstrual disorders in Polish adolescent girls:Prevalence and risk factors[J].Journal of Obstetrics and Gynaecology Research,2011,37(9):1216-1221.
[46]谢一民.抑郁症从肝论治探讨[J].现代中西医结合杂志,2009,12:1354,1376.
[47]贾绍燕.从肝论治抑郁症病机探讨[J].辽宁中医药大学学报,2012(7):127-128.
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[49]曹亚芳,王辉皪,董岷,等.从“肝失疏泄”论治经前期综合征探讨[J].辽宁中医药大学学报,2009(12):47-48.
[50]张丽美.经前期综合征与肝失疏泄[J].江西中医药,2005(3):20.
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[52]陈蓉.香芍颗粒临床应用指导建议[J].中国实用妇科与产科杂志,2015(5):419-420.
[53]乔明琦,张惠云,姜坤,等.经前平颗粒多中心、随机双盲双模拟对照治疗经前期综合征肝气逆证403例[J].中国新药杂志,2002,5:389-392.
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[2]Breaux,C.,Hartlage,S.,Gehlert,S.Relationships of premenstrual dysphoric disorder to major depression and anxiety disorders:A re-examination[J].Journal of Psychosomatic Obstetrics and Gynaecol-ogy,2000,21:17-24.
[3]Rubinow,D.R.,Schmidt,P.J.Models for the development and expression of symptoms in premenstrual syndrome[J].Psy-chiatric Clinics of North America,1989,12:53-68.
[4]Stanghellini G,Ballerini M,Presenza S,et al.Abnormal Time Experiences in Major Depression:An Empirical Qualitative Study[J].Psychopathology,2017,50(2):125-140.
[5]Halbreich,U.,J.Endicott.Relationship of dysphoric premenstrual changes to depressive disorders[J].Acta Psychiatr Scand,1985,71(4):331-338.
[6]Halbreich,U.,I.H.Alt,L.Paul,Premenstrual changes.Impaired hormonal homeostasis[J].Endocrinol Metab Clin North Am,1988,17(1):173-194.
[7]Rajshri,Chaudhari S B,Inamdar S.A Study Of Co-morbid Depression And Anxiety In Pre-menstrual Dysphoric Disorder(PMDD)And Its Effect On Quality Of Life(QOL)Among Undergraduate Medical Students:A Descriptive Study[J].INDIANJOURNAL OF PSYCHIATRY.B-9,KANARA BUSINESSCENTRE,OFF LINK RD,GHAKTOPAR-E,MUMBAI,400075,INDIA:MEDKNOW PUBLICATIONS&MEDIA PVTLTD,2017,59(6):S192-S192.
[8]Post RM,Rubinow DR,Ballenger JC.Conditioning and sensitisation in the longitudinal course of affective illness[J].Br JPrychiatr,1986,149:191-201.
[9]Rubinow,D.R.,Roy-Byrne,P.Pre-menstrual syndromes:Overview from a methodologic perspective[J].American Journal of Psychiatry,1984,141:163-172.
[10]Parry,B.L.Postpartum depression inrelation to other reproductive cycle mood changes.In L.J.Miller(Ed.),Postpartummood disorders(1st ed.,21-46)[M].Wash-ington,DC:American Psychiatric Press,1999.
[11]Schuckit,M.A.,Daly,V.,Herrman,G.,et al.Premenstrual symptoms and depression in a university population[J].Dis-eases of the Nervous System,1975,36:516-517.
[12]Wetzel,J.N.,Reich,T.,Mc Clure,J.M.,et al.Premenstrual affective syn-drome in affective disorder[J].British Journal of Psychiatry,1975,127:219-221.
[13]WETZEL RD,REICH T,MCCLURE JM,et al.Premenstrual affective syndrome and affective disorders[J].Br J Psychiatry,1975,127:219-221.
[14]SCHUCKIT MA,DALY V,HERMAN G,et al.Pre-menstrual symptoms and depression in a university population[J].Dis Nerv Sys,1975,37:516-517.
[15]Graze K K,Nee J,Endicott J.Premenstrual depression predicts future major depressive disorder[J].Acta Psychiatrica Scandinavica,1990,81(2):201-205.
[16]Graze,K.K.,Nee,J.,&Endicott,J.Pre-menstrual depression predicts future ma jor depressive disorder[J].Acta Psychiatrica Scandinavica,1990,81:201-205.
[17]Newman,D.L.,Moffitt,T.E.,Caspi,A.,et al.Comorbid mental disorders:Implications for treatment and sampleselection[J].Journal of Abnormal Psychology,1998,107:305-311.
[18]Hartlage S A,Arduino K E,Gehlert S.Premenstrual dysphoric disorder and risk for major depressive disorder:a preliminary study[J].Journal of Clinical Psychology,2001,57(12):1571-1578.
[19]Chandraiah S,Levenson JL,Collins JB.Sexual dysfunction,social maladjustment,and psychiatric disorders in women seeking treatment in a premenstrual syndrome clinic[J].Sychiatr Med,1991,21:189-204.
[20]Graze IQC,Nee J,Endicott J.Premenstrual depression predicu future major depressive disorder[J].Acta Psychiatr Scand,1990,81:201.
[21]Schucltit MA,Daly V,Herrman G,et al.Premenstrual symptoms and depression in the university population[J].Acta Psychiatr Scand,1975,36:516-517.
[22]Wetzel RD,Reich T,Mc Clure JN Jr,et al.Premenstrual affective syndrome and affective disorder[J].Br J Psychiatr,1975,127:219-221.
[23]De Jong R,Rubinow DR,Roy-Byrne P,et al.Premenstrual mood disorder and psychiatric illness[J].Am J Psychiatr,1985,142:1359-1361.
[24]RICE S A,MARSHALL JR W N.Differential Diagnosis and Comorbidity[M].ADHD in Preschool Children:Assessment and Treatment,2013:66.
[25]Accortt,E.E.,Allen,J.J.B.Frontal EEG asymmetry and premenstrual dysphoricsymptomatology[J].Journal of Abnormal Psychology,2006(1):179-184.
[26]Accortt,E.E.,Stewart,J.L.,Coan,J.A.,et al.Prefrontal brainasymmetry and pre-menstrual dysphoric disorder symptomatology[J].Journal of Affective Disorders,2011b,28(1-2):178-183.
[27]Fava M,Pedrazzi F,Guaraldi GP,et al.Comorbid anxiety and depression among patients with late luteal phase dysphoricdisorder[J].J Anxiety Dis,1992,6:325-335.
[28]Severino SK,Hurt SW,Shindledecker RD.Spectral analysis of cyclic symptoms in late luteal phase dysphoric disorder[J].Am J Psychiatr,1989,146:1155-1160.
[29]Halbreich U.Premenstrual dysphoric disorders,anxiety,and depressions:vulnerability traits or comorbidity[J].Arch Grn iatr,1995,52:606.
[30]Perkonigg A,Yonkers K A,Pfister H,et al.Risk factors for premenstrual dysphoric disorder in a community sample of young women:the role of traumatic events and posttraumatic stress disorder[J].Journal of Clinical Psychiatry,2004,65(10):1314-1322.
[31]Tschudin S,Bertea P C,Zemp E.Prevalence and predictors of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample[J].Archives of Women,s Mental Health,2010,13(6):485-494.
[32]Keye W.Premenstrual syndrome.In Proceedings of a conference on PMS and related biobehavioral disorders[J].BYU Division of Conferences,Provo,UT,1983:1-10.
[33]乔明琦,张惠云,王海军.愤怒和郁怒与经前期综合征肝气逆证肝气郁证相关性研究[J].陕西中医,2006,27(11):1359-1361.
[34]Sndergaard S,Vgter H B,Erlangsen A,et al.Prevalence of depression and anxiety in patients with chronic non-malignant pain-A Danish register-linkage cohort study[J].European Psychiatry,2017,41:S313.
[35]WEISSMAN MM,BOYD JH.The epidemiology of affective disorders.In:POST RM,BALLENGER JC,eds.The neurobiology of mood disorders[M].Baltimore,MD:William&Wilkins,1984:60-75.
[36]Noble,R.E.Depression in women[J].Metabolism,2005,54(5 Suppl 1):49-52.
[37]Hankin B L,Abramson L Y,Moffitt T E,et al.Development of depression from preadolescence to young adulthood:emerging gender differences in a 10-year longitudinal study[J].Journal of Abnormal Psychology,1998,107(1):128.
[38]Wichstr.The emergence of gender difference in depressed mood during adolescence:The role of intensified gender socialization[J].Developmental psychology,1999,35(1):232.
[39]Hankin B L,Abramson L Y.Development of gender differences in depression:An elaborated cognitive vulnerability-transactional stress theory[J].Psychological bulletin,2001,127(6):773.
[40]Petersen A C,Compas B E,Brooks-Gunn J,et al.Depression in adolescence[J].American Psychologist,1993,48(2):155.
[41]Tschudin S,Bertea P C,Zemp E.Prevalence and predictors of premenstrual syndrome and premenstrual dysphoric disorder in a population-based sample[J].Archives of Women,s Mental Health,2010,13(6):485-494.
[42]Robinson R L,Swindle R W.Premenstrual symptom severity:impact on social functioning and treatment-seeking behaviors[J].Journal of Women,s Health&Gender-based Medicine,2000,9(7):757-768.
[43]Deuster P A,Adera T,South-Paul J.Biological,social,and behavioral factors associated with premenstrual syndrome[J].Archives of Family Medicine,1999,8(2):122.
[44]邹志勇,马军,王海俊,等.中国7-17岁青春期女生月经初潮较早与血压水平的关系[J].中华预防医学杂志,2013,47(8):726-730.
[45]Drosdzol A,Nowosielski K,Skrzypulec V,et al.Premenstrual disorders in Polish adolescent girls:Prevalence and risk factors[J].Journal of Obstetrics and Gynaecology Research,2011,37(9):1216-1221.
[46]谢一民.抑郁症从肝论治探讨[J].现代中西医结合杂志,2009,12:1354,1376.
[47]贾绍燕.从肝论治抑郁症病机探讨[J].辽宁中医药大学学报,2012(7):127-128.
[48]贺稚平.从肝论治经前期紧张综合征[J].北京中医药大学学报,1995,6:47-48.
[49]曹亚芳,王辉皪,董岷,等.从“肝失疏泄”论治经前期综合征探讨[J].辽宁中医药大学学报,2009(12):47-48.
[50]张丽美.经前期综合征与肝失疏泄[J].江西中医药,2005(3):20.
[51]乔明琦,张珍玉,徐旭杰,等.经前期综合征证候分布规律的流行病学调查研究[J].中国中医基础医学杂志,1997,3(3):31-32.
[52]陈蓉.香芍颗粒临床应用指导建议[J].中国实用妇科与产科杂志,2015(5):419-420.
[53]乔明琦,张惠云,姜坤,等.经前平颗粒多中心、随机双盲双模拟对照治疗经前期综合征肝气逆证403例[J].中国新药杂志,2002,5:389-392.
[54]章洪流,王天芳,郭文,等.抑郁症中医证型的近10年文献分析[J].北京中医药大学学报,2005,28(3):79-81.
[55]韩旭,范圣凯,等.抑郁症的辨证施治临床观察50例[J].北京中医杂志,2003,22(1):31-32.
[56]FACCHINETTI F,NAPPI G,PETRAGLIA F,et al.Oestradiol/progesterone imbalance and the premenstrual syndrome[J].Lancet,1983:2:1302.
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