The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression
The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression
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DOI：
10.1176/appi.ajp.161.4.631
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发表时间：
2004-04-01
影响因子：
17.7
通讯作者：
Prescott, CA
中科院分区：
文献类型：
--
作者：
Kendler, KS;Kuhn, J;Prescott, CA
目的：重度抑郁症的三个潜在危险因素是女性、神经质的人格特征以及因生活压力事件而导致的逆境。人们对它们在抑郁症病因学中的相互关系知之甚少。 方法：在来自人口样本的 7,500 多个双胞胎个体中，作者根据过去一年中先前评估的神经质、性和逆境，使用 Cox 比例风险模型来预测最近一次访谈的前一年 DSM-III-R 重度抑郁症的发作；逆境被操作化为从 15 个生活事件类别中进行评分的长期背景威胁。结果：在预测抑郁发作的最佳拟合 Cox 模型中，神经质、女性和更大的逆境都会大大增加患重度抑郁症的风险。神经质和逆境之间存在相互作用，因此高度神经质的人患重度抑郁症的总体风险更大，并且对逆境的抑郁作用更敏感。逆境与性之间也存在相互作用，因为女性患重度抑郁症的额外风险仅限于压力较低的个体。结论：在重度抑郁症的病因学中，心理社会逆境与神经质和性相互作用。神经质对疾病风险的影响在高水平逆境时比在低水平逆境时更大，而性别对发病概率的影响则相反，在低水平压力时比在高水平逆境时更大。重度抑郁症的完整病因模型应纳入危险因素类别之间的相互作用。
Objective: Three potent risk factors for major depression are female sex, the personality trait of neuroticism, and adversity resulting from exposure to stressful life events. Little is known about how they interrelate in the etiology of depressive illness.Method: In over 7,500 individual twins from a population-based sample, the authors used a Cox proportional hazard model to predict onsets of episodes of DSM-III-R major depression in the year before the latest interviews on the basis of previously assessed neuroticism, sex, and adversity during the past year; adversity was operationalized as the long-term contextual threat scored from 15 life event categories.Results: In the best-fit Cox model for prediction of depressive onsets, neuroticism, female sex, and greater adversity all strongly increased risk for major depression. An interaction was seen between neuroticisim and adversity such that individuals with high neuroticism were at greater overall risk for major depression and were more sensitive to the depressogenic effects of adversity. An interaction was also seen between adversity and sex, as the excess risk for major depression in women was confined to individuals with low stress exposure.Conclusions: Psychosocial adversity interacts both with neuroticism and with sex in the etiology of major depression. The impact of neuroticism on illness risk is greater at high than at low levels of adversity, while the effect of sex on probability of onset is the opposite-greater at low than at high levels of stress. Complete etiologic models for major depression should incorporate interactions between risk factor classes.