Department of Psychology, City College of New York, New York, NY 10031, USA.
Soc Psychiatry Psychiatr Epidemiol. 2013 Feb;48(2):257-63. doi: 10.1007/s00127-012-0540-7. Epub 2012 Jul 3.
A variety of studies suggest the existence of a distinct phenotype of somatic depression, i.e., depression accompanied by significant somatic symptomatology. Previous research suggests that the gender difference in the prevalence of depression is primarily due to a difference in somatic depression. The aim of this study was to compare the gender difference in the prevalence of somatic depression and of depression not accompanied by significant somatic symptomatology (labelled "pure" depression) in two representative samples, the National Comorbidity Survey-Replication (NCS-R) and the Zurich Study.
The gender difference in lifetime somatic depression was compared to that of pure depression based on analyses weighted back to the general population in two representative samples. The NCS-R analyses involved a narrow definition of somatic depression with items from the DSM criteria for depression--appetite, sleep, and fatigue. The analysis of the Zurich study added headaches, body image issues, and breathing difficulties to the criteria and comparison to atypical depression.
In both samples, the gender difference in depressive prevalence was due to a large difference in somatic depression with other phenotypes showing little or no gender difference. The gender differences were found to be due to the somatic symptoms rather than the number of symptoms and were much larger for somatic than for atypical depression.
The gender difference in the prevalence of depression results from the higher prevalence among women of a specific phenotype, somatic depression.
多项研究表明存在明显的躯体性抑郁表现型，即伴有明显躯体症状的抑郁。既往研究表明，抑郁发病率的性别差异主要归因于躯体性抑郁的差异。本研究旨在比较两个代表性样本（国家共病调查-再测（NCS-R）和苏黎世研究）中躯体性抑郁和不伴有明显躯体症状的抑郁（称为“纯”抑郁）的发病率的性别差异。
根据两个代表性样本中针对总体人群进行加权分析，比较了终生躯体性抑郁的性别差异与纯抑郁的性别差异。NCS-R 分析采用了DSM 抑郁标准中的项目对躯体性抑郁进行狭义定义，包括食欲、睡眠和疲劳。对苏黎世研究的分析则将头痛、身体意象问题和呼吸困难纳入标准，并与非典型抑郁进行了比较。
在两个样本中，抑郁发病率的性别差异归因于躯体性抑郁的巨大差异，而其他表现型则几乎没有或没有性别差异。性别差异归因于躯体症状，而不是症状数量，并且躯体性抑郁的性别差异比非典型抑郁的性别差异大得多。
抑郁发病率的性别差异源于女性中一种特定表现型，即躯体性抑郁的更高发病率。
