Department of Psychology, Saint Louis University, 221 N. Grand Blvd., Saint Louis, MO 63103, USA.
Physiol Behav. 2011 Aug 3;104(2):180-6. doi: 10.1016/j.physbeh.2011.03.004. Epub 2011 Mar 17.
Major depressive disorder (MDD) is associated with alterations in stress physiology. Severe melancholic depression is characterized by hypercortisolism, but community dwelling mildly depressed individuals and those with remitted MDD have shown reduced or normal reactivity to stress. There are also pronounced sex differences both in the incidence of MDD and in stress reactivity. To explore the relationships among depression history, sex differences, and stress, we examined stress reactivity in people with and without a history of MDD. Twenty-two participants with remitted MDD (12 men and 10 women) and 36 never depressed comparison participants (22 men and 14 women) participated in the study. Cortisol and alpha-amylase (sAA) were sampled from saliva before, 10 min after, and 30 min after the Trier Social Stress Test (TSST). Participants filled out the Positive Affect Negative Affect Schedule (PANAS) before and after they underwent the TSST. Women with remitted MDD showed reduced cortisol response to the TSST compared with the never MDD women, while men with remitted MDD showed comparable cortisol reactivity to the never depressed men. The groups did not differ on sAA reactivity to stress. The remitted MDD group (overall and men and women separately) reported greater negative affect both before and after stress compared to the never depressed group. Women from both groups reported greater post-stress negative affect than men. In contrast, men from both groups reported higher positive affect before and after stress than women. Given that the sex difference findings were not dependent on depression history, self-reported affective differences in response to stress may predate depressive symptoms and contribute to sex differences in depression incidence.
重度抑郁症（MDD）与应激生理学改变有关。严重的忧郁症表现为皮质醇过多症，但社区居住的轻度抑郁患者和缓解期 MDD 患者对压力的反应表现为减少或正常。MDD 的发病率和应激反应也存在明显的性别差异。为了探讨抑郁史、性别差异和应激之间的关系，我们研究了有和没有 MDD 病史的人的应激反应。22 名缓解期 MDD 患者（12 名男性和 10 名女性）和 36 名从未抑郁的对照组参与者（22 名男性和 14 名女性）参加了这项研究。在 Trier 社会应激测试（TSST）前、10 分钟后和 30 分钟后，从唾液中采集皮质醇和α-淀粉酶（sAA）样本。参与者在进行 TSST 前后填写积极情绪和消极情绪量表（PANAS）。与从未患有 MDD 的女性相比，缓解期 MDD 女性的皮质醇对 TSST 的反应降低，而缓解期 MDD 男性的皮质醇反应与从未患有 MDD 的男性相似。两组在 sAA 对压力的反应上没有差异。缓解期 MDD 组（整体以及男性和女性）在应激前后的负面情绪均高于从未抑郁组。两组女性在应激后报告的负面情绪均高于男性。相比之下，两组男性在应激前后的积极情绪均高于女性。由于性别差异的发现与抑郁史无关，因此应激反应中自我报告的情感差异可能先于抑郁症状，并导致抑郁发病率的性别差异。
