Gorwood P
Inserm U894, Centre Psychiatrie et Neurosciences. 2 ter, rue d'Alésia, 75014 Paris, France.
Encephale. 2009 Dec;35 Suppl 7:S306-9. doi: 10.1016/S0013-7006(09)73492-X.
Depressed patients with a familial history of depression are usually considered as more endogenous, with higher severity, therefore with a worst prognosis (regarding for example recurrence risk). The opposition between << neurotic-stress linked depression >> and << endogeneous-genetically related depression >> is being challenge in the present review. Indeed, differences in age at onset and selection bias are probably important confusing factors. The existence of an interaction between the involved vulnerability genes (G) and the triggering stressful events (E) was considered as providing meaningful insight for the respective parts of genetics and the environment. Although this approach is even more fragile regarding required sample sizes (larger) and the problem of false positive results (increased), the G*E approach is seducing as closer to reality, the onset of complex disorders being usually explained by those two risk factors.
有抑郁症家族史的抑郁症患者通常被认为更具内源性，病情更严重，因此预后更差（例如复发风险方面）。在本综述中，“神经症 - 应激相关抑郁症”与“内源性 - 基因相关抑郁症”之间的对立受到了挑战。事实上，发病年龄差异和选择偏倚可能是重要的混淆因素。所涉及的易感性基因（G）与引发应激事件（E）之间存在相互作用，这被认为能为遗传学和环境各自的作用提供有意义的见解。尽管这种方法在所需样本量（更大）和假阳性结果问题（增加）方面更为脆弱，但基因与环境相互作用（G*E）方法更具吸引力，因为它更贴近现实，复杂疾病的发病通常由这两个风险因素来解释。
