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抑郁与焦虑中的性别差异。

Sex Differences in Depression and Anxiety.

作者信息

Pavlidi Pavlina, Kokras Nikolaos, Dalla Christina

机构信息

Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Curr Top Behav Neurosci. 2023;62:103-132. doi: 10.1007/7854_2022_375.

Abstract

Depression and anxiety disorders carry a tremendous worldwide burden and emerge as a significant cause of disability among western societies. Both disorders are known to disproportionally affect women, as they are twice more likely to be diagnosed and moreover, they are also prone to suffer from female-specific mood disorders. Importantly, the prevalence of these affective disorders has notably risen after the COVID pandemic, especially in women. In this chapter, we describe factors that are possibly contributing to the expression of such sex differences in depression and anxiety. For this, we overview the effect of transcriptomic and genetic factors, the immune system, neuroendocrine aspects, and cognition. Furthermore, we also provide evidence of sex differences in antidepressant response and their causes. Finally, we emphasize the importance to consider sex as a biological variable in preclinical and clinical research, which may facilitate the discovery and development of new and more efficacious antidepressant and anxiolytic pharmacotherapies for both women and men.

摘要

抑郁症和焦虑症在全球范围内造成了巨大负担,并且在西方社会中成为导致残疾的重要原因。众所周知,这两种疾病对女性的影响尤为严重,她们被诊断出患有这两种疾病的可能性是男性的两倍,此外,她们还容易患上女性特有的情绪障碍。重要的是,在新冠疫情之后,这些情感障碍的患病率显著上升,尤其是在女性中。在本章中,我们描述了可能导致抑郁症和焦虑症中这种性别差异表现的因素。为此,我们概述了转录组学和遗传因素、免疫系统、神经内分泌方面以及认知的影响。此外,我们还提供了抗抑郁反应中性别差异及其原因的证据。最后,我们强调在临床前和临床研究中考虑性别作为生物学变量的重要性,这可能有助于发现和开发针对女性和男性的新型、更有效的抗抑郁和抗焦虑药物疗法。

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