抑郁障碍的研究现状与展望
Research Status and Prospects of Depressive Disorders
DOI: 10.12677/acm.2025.15123660, PDF,   
作者: 朱 蕾:西安医学院研工部,陕西 西安;空军军医大学第一附属医院心身科,陕西 西安
关键词: 抑郁障碍评估方法个体化治疗方案Depressive Disorders Assessment Methods Individualized Treatment Plans
摘要: 抑郁障碍是最常见的精神疾病之一,全球患病率较高,带来了沉重的疾病负担。抑郁障碍不仅显著增加自杀风险,严重损害患者的社会功能,还与多种慢性躯体疾病相互影响,加重病情。抑郁障碍的病因涉及遗传、环境及神经生物学等多方面因素。本文总结了抑郁障碍的临床分型、评估手段及治疗策略。目前,药物治疗、心理治疗和物理治疗是主要治疗方法,新型药物和神经调控技术为难治性患者提供了新的选择。未来研究应更加注重精准医疗和个体化治疗,为深入理解抑郁障碍的发病机制和改进诊疗策略提供支持。
Abstract: Depressive disorder is one of the most common mental illnesses. It has a high global prevalence and imposes a heavy disease burden. This condition significantly increases the risk of suicide. It also severely impairs patients’ social functioning. Moreover, depressive disorder interacts with various chronic physical diseases, worsening their progression. The etiology of depressive disorder involves genetic, environmental, and neurobiological factors. This article summarizes the clinical subtypes, assessment methods, and treatment strategies for depressive disorder. Currently, pharmacological therapy, psychotherapy, and physical therapy are the main treatment approaches. Novel medications and neuromodulation techniques offer new options for treatment-resistant patients. Future research should focus more on precision medicine and individualized treatment. This will help deepen the understanding of depressive disorder’s pathogenesis and improve diagnostic and therapeutic strategies.
文章引用:朱蕾. 抑郁障碍的研究现状与展望[J]. 临床医学进展, 2025, 15(12): 2329-2334. https://doi.org/10.12677/acm.2025.15123660

参考文献

[1] Jackson, J.L., Kuriyama, A., Bernstein, J. and Demchuk, C. (2022) Depression in Primary Care, 2010-2018. The American Journal of Medicine, 135, 1505-1508. [Google Scholar] [CrossRef] [PubMed]
[2] 黄俊捷, 刘肇瑞, 张婷婷, 等. 中国精神卫生调查的跨世纪历程[J]. 北京大学学报(医学版), 2025, 57(5): 868-874.
[3] 周鹏飞, 肖锋, 杨孝光, 等. 中国中老年人群抑郁症流行现状、地区差异及影响因素研究[J]. 中国循证医学杂志, 2025, 25(3): 273-279.
[4] Momen, N.C., Plana-Ripoll, O., Agerbo, E., Benros, M.E., Børglum, A.D., Christensen, M.K., et al. (2020) Association between Mental Disorders and Subsequent Medical Conditions. New England Journal of Medicine, 382, 1721-1731. [Google Scholar] [CrossRef] [PubMed]
[5] Cui, L., Li, S., Wang, S., Wu, X., Liu, Y., Yu, W., et al. (2024) Major Depressive Disorder: Hypothesis, Mechanism, Prevention and Treatment. Signal Transduction and Targeted Therapy, 9, Article No. 30. [Google Scholar] [CrossRef] [PubMed]
[6] Doley, R., Bhuyan, K., Rafique, Q.T., Gogoi, V. and Barah, P. (2025) Younger and Older Adults with Major Depressive Disorder Exhibit Differential Gut Microbiome and Gut-Brain Axis Features. Proceedings of the Indian National Science Academy, 1-9. [Google Scholar] [CrossRef
[7] Koloi, A., Siregar, N.P.R., Quax, R., Sakellarios, A.I., Lamers, F., Rydin, A., et al. (2025) Immunometabolic Pathways: Investigating Mediators of Major Depressive Disorder and Atherosclerotic Cardiovascular Disease Comorbidity. Biological Psychiatry Global Open Science, 5, Article 100528. [Google Scholar] [CrossRef] [PubMed]
[8] Zisook, S., Reynolds, C.F., Pies, R., Simon, N., Lebowitz, B., Madowitz, J., et al. (2010) Bereavement, Complicated Grief, and DSM, Part 1: Depression. The Journal of Clinical Psychiatry, 71, 955-956. [Google Scholar] [CrossRef] [PubMed]
[9] Reed, G.M., First, M.B., Kogan, C.S., Hyman, S.E., Gureje, O., Gaebel, W., et al. (2019) Innovations and Changes in the ICD‐11 Classification of Mental, Behavioural and Neurodevelopmental Disorders. World Psychiatry, 18, 3-19. [Google Scholar] [CrossRef] [PubMed]
[10] Brailean, A., Curtis, J., Davis, K., Dregan, A. and Hotopf, M. (2019) Characteristics, Comorbidities, and Correlates of Atypical Depression: Evidence from the UK Biobank Mental Health Survey. Psychological Medicine, 50, 1129-1138. [Google Scholar] [CrossRef] [PubMed]
[11] Łojko, D. and Rybakowski, J. (2017) Atypical Depression: Current Perspectives. Neuropsychiatric Disease and Treatment, 13, 2447-2456. [Google Scholar] [CrossRef] [PubMed]
[12] Kalin, N.H. (2020) The Critical Relationship between Anxiety and Depression. American Journal of Psychiatry, 177, 365-367. [Google Scholar] [CrossRef] [PubMed]
[13] Kotov, R., Krueger, R.F., Watson, D., Achenbach, T.M., Althoff, R.R., Bagby, R.M., et al. (2017) The Hierarchical Taxonomy of Psychopathology (HiTOP): A Dimensional Alternative to Traditional Nosologies. Journal of Abnormal Psychology, 126, 454-477. [Google Scholar] [CrossRef] [PubMed]
[14] Marci, C.D., Joshi, K., Severtson, S.G., Breeze, J.L. and Jha, M.K. (2025) Real-World Evaluation of Change in Depressive Symptoms among Patients with Treatment-Resistant Depression Treated with Esketamine. BMC Psychiatry. [Google Scholar] [CrossRef
[15] Timmerby, N., Andersen, J.H., Søndergaard, S., Østergaard, S.D. and Bech, P. (2017) A Systematic Review of the Clinimetric Properties of the 6-Item Version of the Hamilton Depression Rating Scale (HAM-D6). Psychotherapy and Psychosomatics, 86, 141-149. [Google Scholar] [CrossRef] [PubMed]
[16] 钱锦铧, 迟庆杰, 丁文彬, 等. 静息态功能磁共振成像在卒中后抑郁中的研究进展[J]. 磁共振成像, 2025, 16(9): 181-187.
[17] Spinazze, P., Rykov, Y., Bottle, A. and Car, J. (2019) Digital Phenotyping for Assessment and Prediction of Mental Health Outcomes: A Scoping Review Protocol. BMJ Open, 9, e032255. [Google Scholar] [CrossRef] [PubMed]
[18] Cipriani, A., Furukawa, T.A., Salanti, G., Chaimani, A., Atkinson, L.Z., Ogawa, Y., et al. (2018) Comparative Efficacy and Acceptability of 21 Antidepressant Drugs for the Acute Treatment of Adults with Major Depressive Disorder: A Systematic Review and Network Meta-analysis. Focus, 16, 420-429. [Google Scholar] [CrossRef] [PubMed]
[19] Popova, V., Daly, E.J., Trivedi, M., Cooper, K., Lane, R., Lim, P., et al. (2019) Efficacy and Safety of Flexibly Dosed Esketamine Nasal Spray Combined with a Newly Initiated Oral Antidepressant in Treatment-Resistant Depression: A Randomized Double-Blind Active-Controlled Study. American Journal of Psychiatry, 176, 428-438. [Google Scholar] [CrossRef] [PubMed]
[20] Powell, J.G., Garland, S., Preston, K. and Piszczatoski, C. (2019) Brexanolone (Zulresso): Finally, an FDA-Approved Treatment for Postpartum Depression. Annals of Pharmacotherapy, 54, 157-163. [Google Scholar] [CrossRef] [PubMed]
[21] Tokuda, A., Nagumo, Y., Kajino, K., Iio, K., Sakurai, K., Mizuno, S., et al. (2025) Rapid‐Onset Therapeutic Effects of Delta Opioid Receptor Agonists on Depression‐Like Behaviors Induced by Chronic Social Defeat Stress. Neuropsychopharmacology Reports, 45, e70059. [Google Scholar] [CrossRef
[22] Thase, M.E. (2025) A New Direction for Adjunctive Therapy of Difficult-to-Treat Depression: Examining the Role of Orexin Receptor Antagonists. European Archives of Psychiatry and Clinical Neuroscience, 275, 1611-1619. [Google Scholar] [CrossRef] [PubMed]
[23] David, D., Cristea, I. and Hofmann, S.G. (2018) Why Cognitive Behavioral Therapy Is the Current Gold Standard of Psychotherapy. Frontiers in Psychiatry, 9, Article ID: 4. [Google Scholar] [CrossRef] [PubMed]
[24] Kuyken, W., Warren, F.C., Taylor, R.S., Whalley, B., Crane, C., Bondolfi, G., et al. (2016) Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-Analysis from Randomized Trials. JAMA Psychiatry, 73, 565-574. [Google Scholar] [CrossRef] [PubMed]
[25] Gloster, A.T., Walder, N., Levin, M.E., Twohig, M.P. and Karekla, M. (2020) The Empirical Status of Acceptance and Commitment Therapy: A Review of Meta-Analyses. Journal of Contextual Behavioral Science, 18, 181-192. [Google Scholar] [CrossRef
[26] Ebert, D.D., Zarski, A., Christensen, H., Stikkelbroek, Y., Cuijpers, P., Berking, M., et al. (2015) Internet and Computer-Based Cognitive Behavioral Therapy for Anxiety and Depression in Youth: A Meta-Analysis of Randomized Controlled Outcome Trials. PLOS ONE, 10, e0119895. [Google Scholar] [CrossRef] [PubMed]
[27] Gaynes, B.N., Lloyd, S.W., Lux, L., Gartlehner, G., Hansen, R.A., Brode, S., et al. (2014) Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression: A Systematic Review and Meta-Analysis. The Journal of Clinical Psychiatry, 75, 477-489. [Google Scholar] [CrossRef] [PubMed]
[28] Mutz, J., Edgcumbe, D.R., Brunoni, A.R. and Fu, C.H.Y. (2018) Efficacy and Acceptability of Non-Invasive Brain Stimulation for the Treatment of Adult Unipolar and Bipolar Depression: A Systematic Review and Meta-Analysis of Randomised Sham-Controlled Trials. Neuroscience & Biobehavioral Reviews, 92, 291-303. [Google Scholar] [CrossRef] [PubMed]
[29] Lyu, H., Zhao, Y., Chen, J., Wang, D. and Chen, H. (2019) Vagus Nerve Stimulation for Depression: A Systematic Review. Frontiers in Psychology, 10, Article No. 64. [Google Scholar] [CrossRef] [PubMed]
[30] Hermida, A.P., Glass, O.M., Shafi, H. and McDonald, W.M. (2018) Electroconvulsive Therapy in Depression: Current Practice and Future Direction. Psychiatric Clinics of North America, 41, 341-353. [Google Scholar] [CrossRef] [PubMed]