Lyons M J, Eisen S A, Goldberg J, True W, Lin N, Meyer J M, Toomey R, Faraone S V, Merla-Ramos M, Tsuang M T
Harvard Institute of Psychiatric Epidemiology and Genetics, USA.
Arch Gen Psychiatry. 1998 May;55(5):468-72. doi: 10.1001/archpsyc.55.5.468.
The only large, registry-based twin study of depression using diagnostic criteria assessed by structured interview included only women. We present results from a comparable study of men.
Data were collected using a standardized telephone interview of men from the Vietnam Era Twin Registry. Both twins from 3372 pairs participated. Proband-wise concordance rates and biometric modeling were used to analyze the data.
The diagnosis of major depression (MD), as defined by DSM-III-R, and the subtype of severe/psychotic MD were significantly affected by genetic (h2=0.36 and 0.39, respectively) and nonshared environmental (e2=0.64 and 0.61, respectively) factors but not by family environmental factors. Dysthymia and mild and moderate MD were affected by family environmental (c2=0.27, 0.08, and 0.14, respectively) and nonshared environmental (e2=0.73, 0.92, and 0.86, respectively) factors but not by genetic factors. Early-onset (before age 30 years) and late-onset (after age 30 years) MD were significantly affected by genetic (h2=0.47 and 0.10, respectively) and nonshared environmental (e2=0.53 and 0.90, respectively) factors. Early-onset MD was significantly more heritable than late-onset MD.
The magnitude of genetic and environmental effects on depression in men is similar to that previously reported in women. Also similar to previous findings, more severe and earlier-onset depression may be more strongly affected by genetic factors, but differences in the reliability of reports of depression associated with severity may inflate estimates of the effect of the unique environment and deflate heritability estimates for less severe depression.
唯一一项基于登记处的大型双胞胎抑郁症研究,采用结构化访谈评估诊断标准,该研究仅纳入了女性。我们展示了一项针对男性的类似研究结果。
通过对越南时代双胞胎登记处的男性进行标准化电话访谈收集数据。3372对双胞胎中的双方都参与了。采用先证者一致率和生物统计学模型对数据进行分析。
由《精神疾病诊断与统计手册》第三版修订本(DSM-III-R)定义的重度抑郁症(MD)诊断以及重度/精神病性MD亚型,分别受到遗传因素(h2分别为0.36和0.39)和非共享环境因素(e2分别为0.64和0.61)的显著影响,但不受家庭环境因素影响。恶劣心境障碍以及轻度和中度MD受到家庭环境因素(c2分别为0.27、0.08和0.14)和非共享环境因素(e2分别为0.73、0.92和0.86)的影响,但不受遗传因素影响。早发型(30岁之前)和晚发型(30岁之后)MD分别受到遗传因素(h2分别为0.47和0.10)和非共享环境因素(e2分别为0.53和0.90)的显著影响。早发型MD的遗传度显著高于晚发型MD。
遗传和环境因素对男性抑郁症的影响程度与之前女性研究报告的相似。同样与之前的研究结果相似,更严重和早发型的抑郁症可能受遗传因素影响更强,但与严重程度相关的抑郁症报告可靠性差异可能会夸大独特环境效应的估计值,并压低对不太严重抑郁症的遗传度估计值。