Zlotnick C, Shea M T, Pilkonis P A, Elkin I, Ryan C
Department of Psychiatry and Human Behavior, Brown University, Providence, RI 02906, USA.
Am J Psychiatry. 1996 Aug;153(8):1021-7. doi: 10.1176/ajp.153.8.1021.
The present study investigated gender differences in depressive symptoms during a naturalistic follow-up for outpatients with major depressive disorder in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Specifically, the study investigated whether gender interacted with type of treatment received, dysfunctional attitudes, life events, or social support to predict severity of depressive symptoms. In addition, aspects of these psychosocial factors (need for approval, interpersonal life events, and close friendships), hypothesized to be more salient for women, were examined to determine if they had a differential impact on level of depressive symptoms in men and women.
Assessments conducted 6, 12, and 18 months after treatment included measures of depressive symptoms, dysfunctional attitudes, current life events, and social support. Data were available for 188 subjects (134 women and 54 men). Regression analyses were conducted to examine whether gender as a main effect, or interacting with dysfunctional attitudes, life events, social support, or subtypes of these variables, predicted cross-sectional or longitudinal measures of depressive symptoms during follow-up.
A consistent finding of the study was that over the 18 months of this naturalistic follow-up, there were no main effects for gender or any significant interactions involving gender and any of the variables of interest. The study demonstrated that life events and social support were related to severity of depressive symptoms for both genders.
Despite differential prevalence rates of major depression for men and women, findings do not support a different process in outcome of illness for men and women.
在国立精神卫生研究所抑郁症协作研究项目中，本研究对重度抑郁症门诊患者进行自然随访，调查抑郁症状的性别差异。具体而言，该研究调查了性别是否与所接受的治疗类型、功能失调性态度、生活事件或社会支持相互作用，以预测抑郁症状的严重程度。此外，还对这些心理社会因素的某些方面（寻求认可的需求、人际生活事件和亲密友谊）进行了研究，这些方面被认为对女性更为突出，以确定它们对男性和女性抑郁症状水平是否有不同影响。
在治疗后6个月、12个月和18个月进行的评估包括抑郁症状、功能失调性态度、当前生活事件和社会支持的测量。共有188名受试者（134名女性和54名男性）的数据可用。进行回归分析，以检验性别作为主效应，或与功能失调性态度、生活事件、社会支持或这些变量的亚型相互作用，是否能预测随访期间抑郁症状的横断面或纵向测量值。
该研究的一个一致发现是，在这18个月的自然随访中，性别没有主效应，性别与任何感兴趣的变量之间也没有显著的相互作用。该研究表明，生活事件和社会支持与男女两性的抑郁症状严重程度均相关。
尽管男性和女性患重度抑郁症的患病率不同，但研究结果并不支持男女在疾病转归过程上存在差异。
