Silverstein Brett
Department of Psychology, City College of New York, NY 10031, USA.
Am J Psychiatry. 2002 Jun;159(6):1051-2. doi: 10.1176/appi.ajp.159.6.1051.
Using data from the Epidemiologic Catchment Area (ECA) study, the author attempted to replicate the finding of the National Comorbidity Survey that the prevalence of depression associated with somatic symptoms was much higher among women than men.
The author reanalyzed data from the ECA study. He divided respondents into those who met criteria for major depression and exhibited appetite and sleep disturbances and fatigue (somatic depression) and those who met depression criteria but did not exhibit all of these somatic criteria (pure depression).
The reanalysis revealed that the prevalence of somatic depression but not pure depression was much higher among women than men. Somatic depression was associated with high rates of pain; among women, it was associated with high rates of anxiety disorders and chronic dysphoria.
The gender difference in depression may result from a difference in a specific type of depression-anxious somatic depression.
利用流行病学集水区（ECA）研究的数据，作者试图重现国家共病调查的结果，即伴有躯体症状的抑郁症患病率在女性中比男性高得多。
作者重新分析了ECA研究的数据。他将受访者分为符合重度抑郁症标准且有食欲和睡眠障碍及疲劳症状的（躯体性抑郁症）和符合抑郁症标准但未表现出所有这些躯体标准的（单纯抑郁症）。
重新分析显示，躯体性抑郁症而非单纯抑郁症的患病率在女性中比男性高得多。躯体性抑郁症与高疼痛发生率相关；在女性中，它与高焦虑症和慢性烦躁发生率相关。
抑郁症的性别差异可能源于一种特定类型的抑郁症——焦虑性躯体抑郁症的差异。
