Vigod Simone N, Stewart Donna E
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Curr Opin Psychiatry. 2009 Jul;22(4):396-400. doi: 10.1097/YCO.0b013e3283297127.
In recent years, there has been an increased appreciation of gender and sex differences in mental illness. This perspective has included attention to sex differences in neurobiology, neurochemistry, sex steroids, endocrine sex reactivity and psychosocial stressors. However, emerging research investigating gene-environment interactions presents another layer of complexity in understanding sex differences in epidemiology, clinical features and treatment of mental disorders across the lifespan.
The main themes in the current literature point to gene-environment interactions underlying sex-specific differences in the psychiatric sequelae of both early childhood and current life stress. Evidence related to the serotonin-linked polymorphic region (5HTTLPR) polymorphism is strongest, but evidence exists for other candidate genes. There is also emerging support for genetic factors that increase susceptibility of some women to hormonal changes of the reproductive life cycle. The interaction of these genetic factors with various environmental stressors, many of which are more common in women, may increase the risk of mental illness, especially mood disorders.
Further research into sex-specific gene-environment interactions across the lifespan is needed with the goal of improving preventive efforts and optimizing treatment in women's mental health.
近年来,人们越来越认识到精神疾病中的性别差异。这一观点涵盖了对神经生物学、神经化学、性类固醇、内分泌性反应和社会心理应激源中性别差异的关注。然而,新兴的关于基因-环境相互作用的研究在理解精神障碍在整个生命周期中的流行病学、临床特征和治疗方面的性别差异时又增加了一层复杂性。
当前文献中的主要主题指出,基因-环境相互作用是儿童早期和当前生活压力所致精神后遗症中性别特异性差异的基础。与血清素相关多态性区域(5HTTLPR)多态性相关的证据最为有力,但其他候选基因也有相关证据。对于增加部分女性对生殖生命周期激素变化易感性的遗传因素也有越来越多的支持。这些遗传因素与各种环境应激源的相互作用,其中许多在女性中更为常见,可能会增加精神疾病尤其是情绪障碍的风险。
需要对整个生命周期中性别特异性的基因-环境相互作用进行进一步研究,目标是改善预防措施并优化女性心理健康治疗。