精神醫學

精神醫學（粵拼：zing1 san4 ji1 hok6；英文：psychiatry），又叫精神病學zing1 san4 beng6 hok6、精神科zing1 san4 fo1，係醫學嘅其中一門專科，專門醫治同預防精神障礙。

常見問題

一個人喺度吸毒；吸毒嘅人好多時都會覺得毒品令佢哋好有快感－精神醫學嘅研究者就自然懷疑呢種行為同犒賞系統有關。

上癮

上癮（addiction）係指一個人重複係噉吸食某啲物質（例：毒品、煙草或者酒呀噉）或者做某樣行為（例：賭錢或者打機），而佢嘅呢種傾向對佢或者第啲人造成損害－例如吸毒吸到傷咗身或者爛賭賭到屋企破產呀噉。

上癮同個腦嘅前額皮層（prefrontal cortex；包括埋扣帶皮層前部同眶額皮質）好有啦掕：呢啲腦區都識得由中腦度接收訊號；除咗掌管（會幫個人抵抗毒品嘅誘惑嘅）自控能力之外，前額皮層嘅結構仲會幫手產生環境提示（environment cue）同吸毒行為之間嘅連繫^[1]－例如家陣個人有好幾次都係一去到酒吧就吸毒，前額皮層會幫手令佢將「酒吧嘅環境」（環境提示）同「又夠鐘吸毒」（行為）聯想埋一齊，搞到佢次次一去到酒吧就有股癮想去吸毒，而研究指呢種環境提示同行為之間嘅連繫係吸毒上癮嘅主因之一，仲可以搞到一個人喺戒咗毒好耐之後先至嚟毒癮返發，例：明明戒咗毒成幾年咁耐，但一返去第一次接觸毒品嗰間酒吧就毒癮返發^[2]。

抑鬱症

抑鬱症（major depression）係一種心理病，病人會持續（超過最少兩個禮拜）覺得情緒低落同埋覺得冇嗮人生嘅樂趣呀噉，嚴重起上嚟仲可以出現自殺嘅傾向^[3]。

精神醫學上有深入噉研究「抑鬱症要點樣應付」呢條問題，而廿一世紀初開始興起咗用對犒賞系統（reward system）嘅刺激嚟治療抑鬱症：神經科學界喺 1950 年代開始有方法將電極安全噉植入去人嘅腦嗰度，並且透過呢啲電極嚟刺激個人嘅特定腦區（腦深層刺激）；有研究抑鬱症嘅科學家就開始對呢種技術有興趣－抑鬱症嘅其中一個病徵係失樂（anhedonia），指病人對原本有興趣嘅活動（例如係不嬲玩開嘅嗜好）冇嗮興趣，而神經科學研究表明，抑鬱症往往涉及多個犒賞系統腦區－包括前額皮層同 NAc ^[4]－嘅活動弱得滯，所以呢啲科學家就喺度諗緊試吓用腦深層刺激嘅技術，用電極刺激抑鬱症病人嘅 NAc，諗住噉做可以人工噉令病人感受到多啲快感，而廿一世紀初嘅研究發現，呢種做法的確有助舒緩抑鬱症嘅失樂症狀^[5]^[6]。

睇埋

攷

↑ Burgos-Robles, A., Kimchi, E. Y., Izadmehr, E. M., Porzenheim, M. J., Ramos-Guasp, W. A., Nieh, E. H., ... & Tye, K. M. (2017). Amygdala inputs to prefrontal cortex guide behavior amid conflicting cues of reward and punishment (PDF). Nature neuroscience, 20(6), 824-835.
↑ Perry, C. J., Zbukvic, I., Kim, J. H., & Lawrence, A. J. (2014). Role of cues and contexts on drug‐seeking behaviour (PDF). British journal of pharmacology, 171(20), 4636-4672.
↑ American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 160-68.
↑ Bewernick, B. H., Kayser, S., Sturm, V., & Schlaepfer, T. E. (2012). Long-term effects of nucleus accumbens deep brain stimulation in treatment-resistant depression: evidence for sustained efficacy (PDF). Neuropsychopharmacology, 37(9), 1975-1985.
↑ Schlaepfer, T. E., Cohen, M. X., Frick, C., Kosel, M., Brodesser, D., Axmacher, N., ... & Sturm, V. (2008). Deep brain stimulation to reward circuitry alleviates anhedonia in refractory major depression (PDF). Neuropsychopharmacology, 33(2), 368-377.
↑ Schlaepfer, T. E., Bewernick, B. H., Kayser, S., Hurlemann, R., & Coenen, V. A. (2014). Deep brain stimulation of the human reward system for major depression - rationale, outcomes and outlook (PDF). Neuropsychopharmacology, 39(6), 1303-1314.

[1] Burgos-Robles, A., Kimchi, E. Y., Izadmehr, E. M., Porzenheim, M. J., Ramos-Guasp, W. A., Nieh, E. H., ... & Tye, K. M. (2017). Amygdala inputs to prefrontal cortex guide behavior amid conflicting cues of reward and punishment (PDF). Nature neuroscience, 20(6), 824-835.

[2] Perry, C. J., Zbukvic, I., Kim, J. H., & Lawrence, A. J. (2014). Role of cues and contexts on drug‐seeking behaviour (PDF). British journal of pharmacology, 171(20), 4636-4672.

[3] American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 160-68.

[4] Bewernick, B. H., Kayser, S., Sturm, V., & Schlaepfer, T. E. (2012). Long-term effects of nucleus accumbens deep brain stimulation in treatment-resistant depression: evidence for sustained efficacy (PDF). Neuropsychopharmacology, 37(9), 1975-1985.

[5] Schlaepfer, T. E., Cohen, M. X., Frick, C., Kosel, M., Brodesser, D., Axmacher, N., ... & Sturm, V. (2008). Deep brain stimulation to reward circuitry alleviates anhedonia in refractory major depression (PDF). Neuropsychopharmacology, 33(2), 368-377.

[6] Schlaepfer, T. E., Bewernick, B. H., Kayser, S., Hurlemann, R., & Coenen, V. A. (2014). Deep brain stimulation of the human reward system for major depression - rationale, outcomes and outlook (PDF). Neuropsychopharmacology, 39(6), 1303-1314.

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