Kendler K S, Prescott C A
Department of Psychiatry, Medical College of Virginia, Commonwealth University College of Medicine, Richmond 23298-0126, USA.
Arch Gen Psychiatry. 1999 Jan;56(1):39-44. doi: 10.1001/archpsyc.56.1.39.
Women report higher rates of major depression (MD) than men. Although genetic factors play an important etiologic role in MD, we are uncertain whether genetic factors are of equal importance in men and women, and whether the same genetic factors predispose men and women to MD.
We obtained, by telephone interview, a lifetime history of MD, defined by the DSM-III-R, from 3790 complete male-male, female-female, and male-female twin pairs, identified through a population-based registry. Results were analyzed using probandwise concordance, odds ratios, and biometrical twin modeling.
The odds ratios (plus tetrachoric correlations) for lifetime MD were as follows: (1) male-male monozygotic, 3.29 (+0.37); (2) male-male dizygotic, 1.86 (+0.20); (3) female-female monozygotic, 3.02 (+0.39); (4) female-female dizygotic, 1.59 (+0.18); and (5) male-female dizygotic, 1.39 (+0.11). In the best-fitting twin model, the heritability of liability to MD was the same in men and women and equal to 39%, while the remaining 61% of the variance in liability was due to individual-specific environment. We rejected, with only modest confidence, the hypothesis that the genetic risk factors for MD were the same in men and women. The best-fitting model estimated the genetic correlation in the liability to MD in the 2 sexes to be +0.57. While we found no evidence to suggest a violation of the equal environment assumption, MD was less common in women from opposite-sex vs same-sex twin pairs.
Major depression is equally heritable in men and women, and most genetic risk factors influence liability to MD similarly in the 2 sexes. However, genes may exist that act differently on the risk for MD in men vs women.
女性报告的重度抑郁症（MD）发病率高于男性。尽管遗传因素在MD的病因中起重要作用，但我们不确定遗传因素在男性和女性中是否同等重要，以及相同的遗传因素是否使男性和女性易患MD。
通过电话访谈，我们从基于人群登记处识别出的3790对同性（男性-男性、女性-女性）和异性（男性-女性）双胞胎中获取了由《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）定义的MD终生病史。使用先证者一致率、比值比和双生子生物统计学模型分析结果。
终生患MD的比值比（加上四分相关系数）如下：（1）男性-男性同卵双胞胎，3.29（+0.37）；（2）男性-男性异卵双胞胎，1.86（+0.20）；（3）女性-女性同卵双胞胎，3.02（+0.39）；（4）女性-女性异卵双胞胎，1.59（+0.18）；（5）男性-女性异卵双胞胎，1.39（+0.11）。在最佳拟合双生子模型中，MD易感性的遗传度在男性和女性中相同，均为39%，而其余61%的易感性差异归因于个体特异性环境。我们以适度的置信度拒绝了MD的遗传风险因素在男性和女性中相同的假设。最佳拟合模型估计两性中MD易感性的遗传相关性为+0.57。虽然我们没有发现证据表明违反了同等环境假设，但与同性双胞胎相比，MD在异性双胞胎中的女性中不太常见。
重度抑郁症在男性和女性中的遗传度相同，大多数遗传风险因素对两性中MD易感性的影响相似。然而，可能存在对男性和女性MD风险有不同作用的基因。
