Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Graduate Program in Neuroscience, University of British Columbia, Vancouver, BC, Canada; Department of Psychology, University of British Columbia, Vancouver, BC, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada.
Prog Neurobiol. 2019 May;176:86-102. doi: 10.1016/j.pneurobio.2019.01.006. Epub 2019 Feb 2.
Depression represents a global mental health concern, and disproportionally affects women as they are twice more likely to be diagnosed than men. In this review, we provide a summary of evidence to support the notion that differences in depression between men and women span multiple facets of the disease, including epidemiology, symptomology, treatment, and pathophysiology. Through a lens of biological sex, we overview depression-related transcriptional patterns, changes in neuroanatomy and neuroplasticity, and immune signatures. We acknowledge the unique physiological and behavioral demands of pregnancy and motherhood by devoting special attention to depression occurring in the peripartum period. Specifically, we discuss issues surrounding the presentation, time course, treatment, and neurobiology of peripartum depression. We write this review with the intention of highlighting the encouraging advancements in our understanding of sex differences in depression, while underscoring the gaps that remain. A more systematic consideration of biological sex as a variable in depression research will be critical in the discovery and development of pharmacotherapies that are efficacious for both men and women.
抑郁症是全球关注的精神健康问题,女性受其影响的比例不成比例,是男性的两倍。在这篇综述中,我们总结了支持以下观点的证据:男性和女性之间的抑郁症差异涉及疾病的多个方面,包括流行病学、症状学、治疗和病理生理学。通过生物学性别这一视角,我们概述了与抑郁症相关的转录模式变化、神经解剖学和神经可塑性变化以及免疫特征。我们特别关注围产期发生的抑郁症,承认怀孕和母亲身份带来的独特生理和行为需求。具体来说,我们讨论了围产期抑郁症在表现、病程、治疗和神经生物学方面的问题。我们撰写这篇综述的目的是强调在理解抑郁症的性别差异方面令人鼓舞的进展,同时强调仍然存在的差距。更系统地考虑抑郁症研究中的生物学性别作为一个变量,对于发现和开发对男性和女性都有效的药物治疗方法至关重要。