The objectives of this study were to examine sex differences in depressive symptom patterns in 475 sib pairs with well-defined recurrent major depression and to test the hypotheses that (a) symptom patterns show higher intraclass correlations within same sex sib pairs versus mixed sex sib pairs; and (b) symptoms more associated with women, e.g. atypical depressive and anxiety symptoms, account for differences between male and female siblings within the same family. A total of 878 individuals, with a past history of at least two depressive episodes, were interviewed using the Schedules for Clinical Assessment in Neuropsychiatry interview and diagnosed according to DSM-IV using a computerized scoring program (CATEGO5). Intraclass correlations were compared between mixed and same sex sibs, and a conditional regression analysis in mixed sex sib pairs was performed to test whether specific symptoms account for differences between male and female siblings within the same family. Women showed a significantly earlier onset of depression compared with men (23.0 years, SD=10.6 versus 25.5, SD=12.5 years, P=0.0004), and a significantly greater frequency of several aspects of depressed mood was found in women compared with men, including atypical depressive features of fatiguability, appetite gain, weight gain and hypersomnia. Discordant sib-pair data analyses revealed five symptoms that accounted for the sex differences between siblings (P=.000035): phobia (exp(B)=2.04, P=0.017), hypersomnia (exp(B)=1.37, P=0.055), appetite loss (exp(B)=1.38, P=0.004) and appetite gain (exp(B)=2.19, P<0.001). Sex significantly modifies clinical features of depression and an earlier onset of depression and atypical depressive symptoms occur more frequently in women.

译文

:这项研究的目的是检查475例患有明确复发性重度抑郁症的抑郁同伴对的抑郁症状模式中的性别差异,并检验以下假设:对; (b)与女性更相关的症状,例如非典型的抑郁和焦虑症状是同一个家庭中男性和女性兄弟姐妹之间差异的原因。使用神经精神病学临床评估时间表采访了过去至少经历过两次抑郁发作的878个人,并根据DSM-IV使用计算机评分程序(CATEGO5)进行了诊断。比较了异性同胞和同性同胞之间的类内相关性,并在异性同胞对中进行了条件回归分析,以测试特定症状是否解释了同一家庭中男性和女性同胞之间的差异。与男性相比,女性抑郁症的发作时间要早得多(23.0岁,SD = 10.6对25.5岁,SD = 12.5岁,P = 0.0004),并且与男性相比,女性抑郁情绪的多个方面的发生频率要高得多,包括可征服性,食欲增加,体重增加和失眠的非典型抑郁特征。不一致的同胞对数据分析揭示了导致同胞之间性别差异的五种症状(P = .000035):恐惧症(exp(B)= 2.04,P = 0.017),失眠症(exp(B)= 1.37,P = 0.055 ),食欲不振(exp(B)= 1.38,P = 0.004)和食欲增高(exp(B)= 2.19,P <0.001)。性别显着改变了抑郁症的临床特征,女性更容易发生抑郁症和非典型性抑郁症状。

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