Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
J Affect Disord. 2014 Mar;156:156-63. doi: 10.1016/j.jad.2013.12.011. Epub 2013 Dec 17.
Although an overall gender difference in prevalence of major depressive disorder (MDD) has been well established, several questions concerning gender differences in the clinical manifestation of depression remain. This study aims to identify gender differences in psychopathology, treatment, and public health consequences in patients with MDD.
Baseline data from the Netherlands Study of Depression and Anxiety (NESDA) were used, including 1115 participants (364 men, 751 women, mean age 41 years) with a DSM-IV diagnosis of current MDD. Characteristics studied included symptom profiles, comorbidity, treatment, and public health consequences.
Women reported a younger age of onset of single (27.8 years vs. 31.6 years; p=0.001) and recurrent MDD (24.8 years vs. 27.6 years; p=0.014), a higher comorbidity of panic disorder with agoraphobia (24.9% vs. 17.3%; p=0.006) and life-time overall anxiety disorder (77.6% vs. 71.4%; p=0.029) than men. More men than women suffered from comorbid alcohol dependence or abuse (48.1% vs. 24.5%; p<0.001). An increased prevalence of atypical depression in women (24.6% vs. 17.3%; p=0.009) was found. Women were treated more frequently by an alternative caretaker (20.6% vs. 14.8%; p=0.025), men more often in mental health care organizations (61.0% vs. 53.7%; p=0.025). No gender differences in frequency of medication use or counseling were found.
Cross sectional design.
Main gender differences in the clinical presentation of MDD concerned a younger age of onset, higher anxiety and lower alcohol use comorbidity and higher prevalence of atypical depression in women. These differences were accompanied by differences in health care use.
虽然普遍存在性别差异与重度抑郁症（MDD）的患病率有关，但关于抑郁症临床表现的性别差异仍存在一些问题。本研究旨在确定 MDD 患者的精神病理学、治疗和公共卫生后果方面的性别差异。
使用荷兰抑郁和焦虑研究（NESDA）的基线数据，包括 1115 名（364 名男性，751 名女性，平均年龄 41 岁）符合 DSM-IV 目前 MDD 诊断的参与者。研究的特征包括症状谱、共病、治疗和公共卫生后果。
女性报告的单发性（27.8 岁 vs. 31.6 岁；p=0.001）和复发性 MDD（24.8 岁 vs. 27.6 岁；p=0.014）发病年龄更年轻，伴有广场恐怖症的惊恐障碍（24.9% vs. 17.3%；p=0.006）和终身整体焦虑障碍（77.6% vs. 71.4%；p=0.029）的共病发生率更高。与女性相比，更多的男性患有共病酒精依赖或滥用（48.1% vs. 24.5%；p<0.001）。发现女性非典型抑郁症的患病率增加（24.6% vs. 17.3%；p=0.009）。女性更频繁地由替代看护者治疗（20.6% vs. 14.8%；p=0.025），而男性更多地在精神卫生保健机构接受治疗（61.0% vs. 53.7%；p=0.025）。在药物使用或咨询的频率方面没有发现性别差异。
横断面设计。
MDD 临床表现方面的主要性别差异涉及女性发病年龄更年轻、焦虑程度更高、酒精使用共病率更低、非典型抑郁症的患病率更高。这些差异伴随着医疗保健使用的差异。
