寻求治疗的成年人抑郁症状的性别差异：来自缓解抑郁的序贯治疗方案研究的验证性分析
Sex differences in depression symptoms in treatment-seeking adults: confirmatory analyses from the Sequenced Treatment Alternatives to Relieve Depression study.
作者信息
Marcus Sheila M, Kerber Kevin B, Rush A John, Wisniewski Stephen R, Nierenberg Andrew, Balasubramani G K, Ritz Louise, Kornstein Susan, Young Elizabeth A, Trivedi Madhukar H
机构信息
Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
出版信息
Compr Psychiatry. 2008 May-Jun;49(3):238-46. doi: 10.1016/j.comppsych.2007.06.012. Epub 2008 Mar 4.
BACKGROUND
Although epidemiologic research consistently reports greater prevalence of major depressive disorder in women, small sample sizes in many studies do not allow for full elaboration of illness characteristics. This article examines sex differences in terms of illness attributes in a cohort of 2541 outpatients from across the United States who enrolled in the Sequenced Treatment Alternatives to Relieve Depression study.
METHODS
Confirmatory analyses were performed in 2541 outpatients comparing men and women with regard to sociodemographic features, comorbid Axis I and Axis III conditions, and illness characteristics. Results were compared with those of our previous report on the initial population of the first 1500 individuals enrolled in Sequenced Treatment Alternatives to Relieve Depression study.
RESULTS
In both samples, nearly two thirds of the sample (62.5%) were women. Women had greater symptom severity, but men had more episodes of major depression, despite no difference in the length of illness. No differences in age of onset emerged. As in the first cohort, women showed greater rates of an anxiety disorder, bulimia, and somatoform disorder, as well as more past suicide attempts, whereas men showed more alcohol and substance abuse. Women reported more appetite, weight, hypersomnia, interpersonal sensitivity, gastrointestinal and pain complaints, and less suicidal ideation. Irritability was equally common in men and women.
CONCLUSION
This large analysis confirmed most of the clinical features and comorbidities found to be more prevalent in the first cohort of women. In addition, this analysis corroborated previous research suggesting higher rates of atypical and anxious depression in women but refuted the notion of an "irritable depression" found in men. The report confirmed the 1.7:1 ratio for depression seen across sexes in the National Comorbidity Survey.
背景
尽管流行病学研究一直报告女性中重度抑郁症的患病率更高，但许多研究样本量较小，无法全面阐述疾病特征。本文在一项针对来自美国各地的2541名门诊患者的队列研究中，考察了疾病属性方面的性别差异，这些患者参与了缓解抑郁症的序贯治疗替代方案（Sequenced Treatment Alternatives to Relieve Depression）研究。
方法
对2541名门诊患者进行验证性分析，比较男性和女性在社会人口学特征、共病的轴I和轴III疾病以及疾病特征方面的差异。将结果与我们之前关于缓解抑郁症的序贯治疗替代方案研究中最初纳入的1500名个体的初始人群报告结果进行比较。
结果
在两个样本中，近三分之二的样本（62.5%）为女性。女性的症状严重程度更高，但男性的重度抑郁发作次数更多，尽管病程长度没有差异。发病年龄没有差异。与第一个队列一样，女性焦虑症、贪食症和躯体形式障碍的发生率更高，过去自杀未遂的情况也更多，而男性酒精和药物滥用的情况更多。女性报告有更多的食欲、体重、嗜睡、人际敏感性、胃肠道和疼痛主诉，自杀观念较少。易怒在男性和女性中同样常见。
结论
这项大型分析证实了在第一个女性队列中发现的大多数临床特征和共病更为普遍。此外，该分析证实了先前的研究结果，即女性非典型和焦虑性抑郁症的发生率更高，但反驳了男性存在“激越性抑郁症”的观点。该报告证实了全国共病调查中男女抑郁症1.7:1的比例。
Zotero 插件