Halbreich Uriel, Kahn Linda S
Biobehavior Research, State University of New York at Buffalo, Hayes Annex C Ste # 1, 3435 Main Street, Buffalo, NY 14214, USA.
J Affect Disord. 2007 Sep;102(1-3):245-58. doi: 10.1016/j.jad.2006.09.023. Epub 2006 Nov 7.
Both depression and anxiety disorders affect women at rates significantly greater than men. Women also have a documented higher frequency of comorbid depression and anxiety disorders, and a three-fold higher prevalence of atypical depression.
These gender differences are mainly due to specific depressive phenotypes including anxious depression and atypical depression. The prevalence of comorbid anxiety and depression strongly suggests overlap of pathophysiological mechanisms-which in women are also affected by fluctuations in gonadal hormones. Similar efficacy of serotonergic antidepressants as treatment for anxiety disorders as well as depressions further underscores the blurred boundaries between these two descriptive entities.
Symptoms of depression and anxiety may be a departure point for differential diagnosis in which dimensionally-based phenotypes substantiated by pathobiology would replace current descriptive entities. It is suggested that at least some biologically-based dysphorias may be specific to women, ensuing from the combination of specific vulnerabilities, and complex interactions between brain mechanisms and gonadal hormones.
抑郁症和焦虑症对女性的影响比率显著高于男性。有记录显示，女性共病抑郁症和焦虑症的频率也更高，非典型抑郁症的患病率则高出三倍。
这些性别差异主要归因于特定的抑郁表型，包括焦虑性抑郁和非典型抑郁。共病焦虑症和抑郁症的高患病率强烈表明病理生理机制存在重叠，而在女性中，这些机制也受到性腺激素波动的影响。血清素能抗抑郁药对焦虑症和抑郁症的治疗效果相似，这进一步凸显了这两个描述性实体之间界限的模糊。
抑郁和焦虑症状可能是鉴别诊断的出发点，其中基于维度的、由病理生物学证实的表型将取代当前的描述性实体。建议至少某些基于生物学的烦躁不安可能是女性特有的，是由特定易感性以及大脑机制和性腺激素之间复杂的相互作用共同导致的。
