Breslau N, Chilcoat H, Schultz L R
Department of Psychiatry, Henry Ford Health Sciences Center, One Ford Place, 3A, Detroit, MI 48202, USA.
J Gend Specif Med. 1998 Dec;1(3):33-9.
To examine the role of anxiety disorders in the development of sex differences in the risk of major depression.
An epidemiologic study.
This study surveyed 1007 young adults, randomly selected from a large HMO in southeastern Michigan.
The National Institute of Mental Health's Diagnostic Interview Schedule was administered to measure major depression and specific anxiety disorders (as per Diagnostic and Statistical Manual of Mental Disorders, third edition revised, guidelines). A composite variable--"any anxiety"--was used, and age of onset was defined as the age at which the earliest anxiety disorder began.
Prior anxiety signaled an increased risk for major depression in both sexes. Women were not more vulnerable than men to becoming depressed after an anxiety disorder. Prior anxiety disorders accounted for a considerable part of the sex differences in major depression. Controlling for prior substance use disorder did not alter the results.
Women's higher rates of anxiety disorders might play a role in their higher risk of depression. Substance use disorder is not men's counterpart of anxiety in terms of its potential role in the onset of depression. Future research should address the question of women's greater risk for anxiety disorders. Intervention trials to examine whether effective treatments of anxiety disorders might reduce the risk of depression would shed light on the mechanisms that link anxiety and depression.
探讨焦虑症在重度抑郁症风险性别差异形成中的作用。
一项流行病学研究。
本研究对从密歇根州东南部一家大型健康维护组织中随机选取的1007名年轻人进行了调查。
采用美国国立精神卫生研究所的诊断访谈表来测量重度抑郁症和特定焦虑症（按照《精神疾病诊断与统计手册》第三版修订版指南）。使用了一个复合变量——“任何焦虑症”，并将发病年龄定义为最早出现焦虑症的年龄。
既往焦虑症表明男女患重度抑郁症的风险均增加。焦虑症发作后，女性并不比男性更容易患抑郁症。既往焦虑症在重度抑郁症的性别差异中占相当一部分。控制既往物质使用障碍并未改变结果。
女性较高的焦虑症发病率可能在其较高的抑郁症风险中起作用。就其在抑郁症发病中的潜在作用而言，物质使用障碍并非男性版的焦虑症。未来的研究应解决女性患焦虑症风险更高的问题。通过干预试验来检验焦虑症的有效治疗是否可能降低抑郁症风险，将有助于揭示焦虑症与抑郁症之间的联系机制。
