Department of Psychiatry, Faculty of Medicine, Hospital Santa Maria, University of Lisbon, Lisbon, Portugal.
Curr Opin Psychiatry. 2010 Jul;23(4):369-72. doi: 10.1097/YCO.0b013e3283399b86.
The association between endocrine and neuropsychiatric disorders was established long ago, with solid evidence. According to a multidimensional model of mental disorders, one can conceptualize sex and gender-related endocrinological dysfunctions as a cluster of risk factors included in the biological determinants of those disorders.
Gender and sexual dimorphism in brain functions and pathways may have a main impact and synergistic effects on health differences in both men and women. To explain these differences, hormonal reactivity to stress, sex hormones and gene-environment interactions are among the most researched mechanisms.
In this paper, we review updated data on sex and gender differences in stress reactivity, concerning the hypothalamic-pituitary-adrenal axis, endocrinological dysfunction and vulnerability to major psychiatric disorders, in a stress-diathesis approach. Mainly schizophrenia and affective disorders are discussed, according to recent investigation, in terms of early determinants of stress reactivity, the interplay of genetic expression and gender role, their responsibility in biological modulation and their hypothetical contribution to explain gender differences in prevalence and clinical aspects of mental disorders.
内分泌和神经精神疾病之间的关联很早就已确立，并有确凿的证据支持。根据精神障碍的多维模型，可以将与性别相关的内分泌功能障碍视为包含在这些障碍的生物学决定因素中的一组风险因素。
大脑功能和途径的性别和性别二态性可能对男性和女性的健康差异产生主要影响和协同作用。为了解释这些差异，对压力的激素反应、性激素和基因-环境相互作用是研究最多的机制之一。
在本文中，我们综述了关于应激反应的性别差异的最新数据，涉及下丘脑-垂体-肾上腺轴、内分泌功能障碍和对主要精神疾病的易感性，采用应激素质假说。主要讨论了精神分裂症和情感障碍，根据最近的研究，涉及应激反应的早期决定因素、基因表达和性别角色的相互作用、它们在生物学调节中的作用以及它们对解释精神障碍患病率和临床方面的性别差异的假设贡献。
