抑郁症是常见的精神障碍，以情感低落、思维迟缓、意志活动减退为典型症状。儿童青少年抑郁症具有高复发率、高危 害性、高死亡率及对药物低应答率的特。药物治疗+心理治疗是被国际社会所普遍认同的，但尚无完善且统一针对儿童青少年抑郁群体 的临床心理干预方式，因此亟待一种更加适合儿少抑郁症群体的一种新的治疗模式及方法。正念相关治疗已有循证医学证据证明能有效 改善抑郁症状，自我关怀是基于正念这一核心近年国际上发展的一种新兴的耗时短、易操作的心理治疗方式[1-2]，因此我们可能在临床 上探索出一种更适合缓解青少年抑郁症状的治疗方式。

抑郁症已成为影响青少年精神健康的重要问题.青少年抑郁症(Major Depressive Disorder,MDD)症状不典型,自杀风险较高,治疗安全性要求较高,但药物选择又相对较少,治疗效果和预后与心理因素密切相关,故心理治疗作为重要的干预手段,日渐重视和发展,正念治疗是其中之一,兼具有效性和安全性.本文从理论、实验证据和临床结果等方面对正念疗法在青少年抑郁症中的治疗现状和在青少年群体中的可行性做一综述.

Objective To investigate the differences of peripheral blood DNA methylation in identical twin adolescents with different depressive phenotypes and explore whether these differentially expressed genes can be used as candidate genes involved in the occurrence of depression. Methods Three pairs of verified identical twin adolescents (12~18 years old) were recruited in this study. Phenotypic differences of depression between the twins were determined by Beck Depression Inventory-Ⅱ (BDI-Ⅱ) scores and emotional factor scores of Strength and Difficulty Questionnaire (SDQ) for students. After Infinium MethylationEPIC BeadChip Kit was used to interrogate over 850k methylation sites, those with P < 0.05 and the absolute value difference of methylation β value greater than 0.1 (|△β| >0.1) were selected as the differential methylation sites. Gene Ontology (GO) functional annotation analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, as well as protein-protein interaction (PPI) network were performed to identify important genes associated with major depressive disorder (MDD) and their methylation changes. Results Three pairs of identical twin adolescents with different depressive phenotypes were divided into depressive phenotype group and normal phenotype group. A total of 57 genes with different methylation levels were screened between the 2 groups, including 45 genes with increased and 12 genes with decreased DNA methylation levels. GO analysis showed that differential genes were most significantly enriched in biological processes such as central nervous system development and regulation of RNA metabolic process. KEGG analysis indicated that differential genes were significantly enriched in synaptic long-term depression (LTD), PI3K-Akt signaling pathway and TNF signaling pathway. Besides, direct or indirect interactions between RHOA and several differential methylated genes were found in PPI network. Conclusion Changes in DNA methylation levels of CSF1R, NOS1, AHR and other genes in peripheral blood of identical twins with different depressive phenotypes may regulate gene expression through synaptic long-term depression (LTD), PI3C-Akt and other signaling pathways involved in the occurrence of depression.