Park Seon-Cheol, Lee Min-Soo, Shinfuku Naotaka, Sartorius Norman, Park Yong Chon
Department of Psychiatry, Yong-In Mental Hospital, Yongin, South Korea Institute of Mental Health, Hanyang University, Seoul, South Korea.
Department of Psychiatry, Korea University College of Medicine, Seoul, Korea.
Aust N Z J Psychiatry. 2015 Sep;49(9):833-41. doi: 10.1177/0004867415579464. Epub 2015 Mar 31.
The purpose of this study was to investigate whether there were gender-specific depressive symptom profiles or gender-specific patterns of psychotropic agent usage in Asian patients with depression.
Clinical data from the Research on Asian Psychotropic Prescription Patterns for Antidepressant study (1171 depressed patients) were used to determine gender differences by analysis of covariates for continuous variables and by logistic regression analysis for discrete variables. In addition, a binary logistic regression model was fitted to identify independent clinical correlates of the gender-specific pattern on psychotropic drug usage.
Men were more likely than women to have loss of interest (adjusted odds ratio = 1.379, p = 0.009), fatigue (adjusted odds ratio = 1.298, p = 0.033) and concurrent substance abuse (adjusted odds ratio = 3.793, p = 0.008), but gender differences in other symptom profiles and clinical features were not significant. Men were also more likely than women to be prescribed adjunctive therapy with a second-generation antipsychotic (adjusted odds ratio = 1.320, p = 0.044). However, men were less likely than women to have suicidal thoughts/acts (adjusted odds ratio = 0.724, p = 0.028). Binary logistic regression models revealed that lower age (odds ratio = 0.986, p = 0.027) and current hospitalization (odds ratio = 3.348, p < 0.0001) were independent clinical correlates of use of second-generation antipsychotics as adjunctive therapy for treating depressed Asian men.
Unique gender-specific symptom profiles and gender-specific patterns of psychotropic drug usage can be identified in Asian patients with depression. Hence, ethnic and cultural influences on the gender preponderance of depression should be considered in the clinical psychiatry of Asian patients.
本研究旨在调查亚洲抑郁症患者中是否存在特定性别的抑郁症状谱或精神药物使用模式。
使用亚洲抗抑郁药物处方模式研究(1171名抑郁症患者)的临床数据,通过对连续变量的协变量分析和对离散变量的逻辑回归分析来确定性别差异。此外,拟合二元逻辑回归模型以识别精神药物使用中特定性别模式的独立临床相关因素。
男性比女性更易出现兴趣丧失(调整优势比=1.379,p=0.009)、疲劳(调整优势比=1.298,p=0.033)和并发物质滥用(调整优势比=3.793,p=0.008),但其他症状谱和临床特征的性别差异不显著。男性也比女性更有可能接受第二代抗精神病药物的辅助治疗(调整优势比=1.320,p=0.044)。然而,男性出现自杀念头/行为的可能性低于女性(调整优势比=0.724,p=0.028)。二元逻辑回归模型显示,年龄较小(优势比=0.986,p=0.027)和目前住院(优势比=3.348,p<0.0001)是亚洲男性抑郁症患者使用第二代抗精神病药物作为辅助治疗的独立临床相关因素。
在亚洲抑郁症患者中可以识别出独特的特定性别症状谱和精神药物使用模式。因此,在亚洲患者的临床精神病学中应考虑种族和文化对抑郁症性别优势的影响。