University of Groningen, Faculty of Behavioural and Social Sciences, Department of Child and Family Welfare, Groningen, the Netherlands.
University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Emotion Regulation (ICPE), Groningen, the Netherlands; Research Department, GGZ Friesland, Leeuwarden, the Netherlands.
J Affect Disord. 2024 Jun 1;354:424-433. doi: 10.1016/j.jad.2024.03.031. Epub 2024 Mar 11.
The prevalence of Major Depressive Disorder (MDD) is twice as high in women as in men and this difference already emerges during adolescence. Because the mechanisms underlying this sex-difference remain poorly understood, we took a bottom-up approach to identify factors explaining the sex-MDD relationship.
Data came from the TRacking Adolescents' Individual Lives Survey (TRAILS), a population study investigating youths' development from age 11 into adulthood. We assessed multiple baseline covariates (e.g., demographic, social and psychological) at ages 11-13 years and MDD onset at ages 19 and 25 years. In regression analyses, each covariate's role in the sex-MDD association as an effect modifier or confounder/explanatory variable was investigated. Replicability was evaluated in an independent sample.
The analyses identified no effect-modifiers. Baseline internalizing problems, behavioral inhibition, dizziness, comfort in classroom, physical complaints, attention problems, cooperation, self/effortful control, interpersonal life events and computer use partially explained the association between sex and MDD at age 19. The association between sex and MDD at age 25 was explained by largely the same variables, but also by shyness, acne, antisocial behavior, aggression, affection from peers and time spent shopping. The explanatory roles of internalizing problems, behavioral inhibition, negative events involving gossip/rumors and leisure-time spending (computer-use/shopping) were replicated.
Potentially important baseline variables were not included or had low response rates. Gender roles or identification were not considered. Baseline MDD was not adjusted for.
The sex-MDD association is partially explained by sex differences in symptoms and vulnerability factors already present in early adolescence.
重度抑郁症（MDD）在女性中的患病率是男性的两倍，这种差异早在青春期就出现了。由于导致这种性别差异的机制仍不清楚，我们采用自下而上的方法来确定解释性别与 MDD 关系的因素。
数据来自青少年个体生活追踪研究（TRAILS），这是一项对年轻人从 11 岁到成年的发展进行调查的人群研究。我们在 11-13 岁时评估了多个基线协变量（例如，人口统计学、社会和心理），并在 19 岁和 25 岁时评估了 MDD 发病情况。在回归分析中，我们研究了每个协变量作为效应修饰因子或混杂因子/解释变量在性别与 MDD 关联中的作用。在独立样本中评估了可重复性。
分析未发现效应修饰因子。基线内化问题、行为抑制、头晕、课堂舒适度、身体不适、注意力问题、合作、自我/努力控制、人际关系生活事件和计算机使用部分解释了 19 岁时性别与 MDD 之间的关联。25 岁时性别与 MDD 之间的关联由大部分相同的变量解释，但也由害羞、痤疮、反社会行为、攻击性、同伴的喜爱和购物时间来解释。内化问题、行为抑制、涉及八卦/谣言的负面事件以及休闲时间（计算机使用/购物）的解释作用得到了复制。
未包括或回复率较低的潜在重要基线变量。性别角色或认同未被考虑。基线 MDD 未调整。
性别与 MDD 的关联部分解释了青春期早期已经存在的症状和易感性因素的性别差异。
