Marcus Sheila M, Young Elizabeth A, Kerber Kevin B, Kornstein Susan, Farabaugh Amy H, Mitchell Jeff, Wisniewski Stephen R, Balasubramani G K, Trivedi Madhukar H, Rush A John
Department of Psychiatry, University of Michigan Medical School, 2101 Commonwealth Blvd. Suite B, Ann Arbor, MI 48105, USA.
J Affect Disord. 2005 Aug;87(2-3):141-50. doi: 10.1016/j.jad.2004.09.008.
Epidemiologic research consistently reports gender differences in the rates and course of major depressive disorder (MDD). The STAR*D (Sequenced Treatment Alternatives to Relieve Depression) multicenter trial provides a unique opportunity to explore gender differences in outpatients with nonpsychotic MDD.
This sample included the first 1500 outpatients with MDD who enrolled in STAR*D. Nearly two-thirds of the sample (62.8%) were women. Baseline sociodemographic factors, comorbidities, and illness characteristics were analyzed by gender.
Women (62.8% of the sample) had a younger age at onset of the first major depressive episode. They commonly reported concurrent symptoms consistent with anxiety disorders, somatoform disorder, and bulimia as well as atypical symptoms. Alcohol and drug abuses were more common in men.
This report is a subpopulation of the entire STAR*D sample. These exploratory analyses aimed to identify potential gender differences for further hypothesis testing.
The gender-specific rate of MDD in this study population is proportional to rates found in community samples with a 1.7:1 prevalence of MDD in women vs. men which argues against increased treatment seeking in women.
流行病学研究一直报告称，在重度抑郁症（MDD）的发病率和病程方面存在性别差异。STAR*D（缓解抑郁症的序贯治疗替代方案）多中心试验提供了一个独特的机会，来探究非精神病性MDD门诊患者中的性别差异。
该样本包括首批1500名参与STAR*D试验的MDD门诊患者。样本中近三分之二（62.8%）为女性。按性别对基线社会人口统计学因素、合并症和疾病特征进行了分析。
女性（占样本的62.8%）首次重度抑郁发作的年龄更小。她们通常报告有与焦虑症、躯体形式障碍和贪食症相符的并发症状以及非典型症状。酒精和药物滥用在男性中更为常见。
本报告是整个STAR*D样本的一个亚组。这些探索性分析旨在识别潜在的性别差异，以便进一步进行假设检验。
本研究人群中MDD的性别特异性发病率与社区样本中的发病率成比例，女性与男性的MDD患病率为1.7:1，这表明女性寻求治疗的增加并非事实。
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