Department of Neuroscience, Child Neuropsychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Department of Life Sciences and Public Health, Catholic University, Rome, Italy.
Curr Neuropharmacol. 2023;21(6):1343-1354. doi: 10.2174/1570159X20666221012113458.
Gender differences have been reported in the severity and psychopathological features of major depressive disorders among adults but are poorly reported in adolescent samples.
This study aimed to examine gender differences in the psychopathology of mixed depression among adolescents.
We analyzed 341 outpatients with the current major depressive episode (MDE) retrospectively to identify patients with DSM-5 MDE with mixed features. We compared examiner-rated depressive and (hypo)manic symptoms and self- and parent-reported symptoms between sexes.
We identified 76 patients with an MDE with mixed features (67.1% females, 32.9% with bipolar disorder). Depression severity was significantly greater in females versus males (CDRS-R total score 56.2 vs. 48.2, p = 0.014). Depressive symptoms were significantly and independently found to be more severe among females in a logistic regression model, including excessive fatigue (OR 1.68; p = 0.025), low self-esteem (OR 1.67; p = 0.04), excessive weeping (OR 1.62; p = 0.021), and CBCL AAA index (OR 1.04; p = 0.015). None of the depressive symptoms scored greater in males. Males had higher levels of motor activity (2.12 vs. 1.69; p = 0.048) and pressured speech (1.80 vs. 1.24; p = 0.004). Self-rated anxiety (69.3 vs. 56.8, p = 0.047) and CBCL AAA index (207 vs. 189; p = 0.007) were higher in females.
Adolescent depression with mixed features is more severe in women, with a higher expression of core affective symptoms and excessive fatigue. While in males, slightly higher levels of psychomotor activation are reported, in females, emotional dysregulation and excessive weeping may subtend a difference in a broader spectrum of mixed features.
在成年人的重度抑郁症和精神病理学特征中已经报告了性别差异，但在青少年样本中报道较少。
本研究旨在检查青少年混合性抑郁症的精神病理学中的性别差异。
我们回顾性地分析了 341 名患有当前主要抑郁发作（MDE）的门诊患者，以确定符合 DSM-5 MDE 伴混合特征的患者。我们比较了检查者评定的抑郁和（轻躁狂）症状以及自我和父母报告的症状在性别之间的差异。
我们确定了 76 名患有混合性 MDE 的患者（67.1%为女性，32.9%为双相障碍）。女性的抑郁严重程度显著高于男性（CDRS-R 总分 56.2 比 48.2，p = 0.014）。在逻辑回归模型中，女性的抑郁症状显著且独立地更为严重，包括过度疲劳（OR 1.68；p = 0.025）、自尊心低下（OR 1.67；p = 0.04）、过度哭泣（OR 1.62；p = 0.021）和 CBCL AAA 指数（OR 1.04；p = 0.015）。男性的任何抑郁症状评分均未更高。男性的运动活动水平更高（2.12 比 1.69；p = 0.048）和言语急迫（1.80 比 1.24；p = 0.004）。女性的自我评定焦虑（69.3 比 56.8，p = 0.047）和 CBCL AAA 指数（207 比 189；p = 0.007）更高。
伴混合特征的青少年抑郁症在女性中更为严重，表现为核心情感症状和过度疲劳的表达更高。虽然男性报告了稍高的精神运动激活水平，但在女性中，情绪失调和过度哭泣可能会导致混合特征的更广泛谱中的差异。
