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The role of insulin resistance in the development of depressive symptoms : a systematic review
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As doenças metabólicas constituem uma pandemia crescente, e encontram-se associadas a uma maior prevalência de condições que afetam o bem-estar mental. Pensa-se que a resistência à insulina, uma condição crucial para a fisiopatologia das doenças metabólicas, também participe no desenvolvimento da sintomatologia das perturbações do humor. Esta revisão tem como objetivo clarificar o papel da resistência à insulina na génese dos sintomas depressivos, usando como modelos as perturbações mentais de mais elevada prevalência, a perturbação depressiva e afetivo-bipolar. Foi efetuada uma extensa pesquisa em diversas bases de dados. Foram extraídos dados relativos aos sintomas depressivos, a neuroimagem, a resposta à terapêutica e a opções terapêuticas que pudessem elucidar a relação entre a resistência à insulina e os sintomas depressivos. De 538 artigos identificados, foram selecionados 12, que cumpriam os critérios de inclusão estabelecidos. A resistência à insulina foi associada com um maior risco de desenvolvimento de sintomas depressivos, com um curso de doença mais agressivo e com uma maior resistência à terapêutica das perturbações de humor. O tratamento farmacológico da resistência à insulina teve um importante impacto nos sintomas depressivos, e o tratamento não-farmacológico de perturbações do humor impactaram positivamente a resistência à insulina. Concluindo, a resistência à insulina poderá representar um marcador precoce do desenvolvimento de sintomas depressivos, assim como poderá ser um potencial alvo para terapêutica modificadora da doença das perturbações do humor.
Metabolic diseases are a growing pandemic, they are associated with a higher prevalence of conditions affecting mental well-being. Insulin resistance (IR), while being crucial to the pathophysiology of metabolic diseases, is also thought to be involved in the development of symptomology in mood disorders. This review aims to clarify the role of insulin resistance in the genesis of depressive symptoms, in Major depression and bipolar disorder. An extensive search string was effectuated in diverse databases (PubMed, Cochrane, and Web of Science). findings regarding depressive symptoms were extracted, as well as neuroimaging and treatment responses that could elucidate the relation between insulin resistance and depressive symptoms. Of 538 articles identified, 12 reports fulfilled the inclusion criteria and were therefore included. Insulin resistance was associated with a greater risk of developing depressive symptoms, with worse clinical course and higher treatment resistance in mood disorders. Pharmacological treatments of insulin resistance showed an impact on depressive symptoms and non-pharmacological treatments of mood disorders had an impact on insulin resistance. In conclusion, IR could represent an early marker for the development of depressive symptoms, as well as a potential disease-modifying treatment target.
Metabolic diseases are a growing pandemic, they are associated with a higher prevalence of conditions affecting mental well-being. Insulin resistance (IR), while being crucial to the pathophysiology of metabolic diseases, is also thought to be involved in the development of symptomology in mood disorders. This review aims to clarify the role of insulin resistance in the genesis of depressive symptoms, in Major depression and bipolar disorder. An extensive search string was effectuated in diverse databases (PubMed, Cochrane, and Web of Science). findings regarding depressive symptoms were extracted, as well as neuroimaging and treatment responses that could elucidate the relation between insulin resistance and depressive symptoms. Of 538 articles identified, 12 reports fulfilled the inclusion criteria and were therefore included. Insulin resistance was associated with a greater risk of developing depressive symptoms, with worse clinical course and higher treatment resistance in mood disorders. Pharmacological treatments of insulin resistance showed an impact on depressive symptoms and non-pharmacological treatments of mood disorders had an impact on insulin resistance. In conclusion, IR could represent an early marker for the development of depressive symptoms, as well as a potential disease-modifying treatment target.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Resistência à insulina Sintomas depressivos Perturbação depressiva Perturbação bipolar Perturbação do humor Psiquiatria