Epidemiology of women and depression
Epidemiology of women and depression
复制标题
DOI：
10.1016/s0165-0327(02)00426-3
复制
发表时间：
2003-03-01
影响因子：
6.6
通讯作者：
Kessler, RC
中科院分区：
文献类型：
--
作者：
Kessler, RC
背景：抑郁症是当今世界妇女疾病相关残疾的主要原因。抑郁症在女性中比男性更常见，女性/男性风险比约为2：1。目的：综述近年来流行病学研究进展。建议未来需要的研究的影响。结果：女性抑郁症患病率高于男性是由于首次发病的风险较高，而不是由于持续或复发的差异。虽然性别差异首先出现在青春期。与性激素变化有关的其他经历（怀孕、更年期）。使用口服避孕药和使用激素替代疗法）对重度抑郁症没有显著影响。这些观察结果表明，理解女性抑郁症发病率高于男性的关键在于对生物脆弱性和环境激发经历的联合影响进行调查。结论：进一步了解女性抑郁症将需要未来的流行病学研究集中在第一次发病，并通过性激素和性别相关的环境经验的细粒度的措施，通过青春期过渡到年轻的成年人的事件队列。可能需要通过共同操纵假定的生物和环境风险因素来进行旨在初级预防的实验干预，以在相互关联的风险因素的单独和联合影响方面的相互竞争的因果假设之间做出裁决。(C)2002 Elsevier Science B. V.保留所有权利。
Background: Depression is the leading cause of disease-related disability among women in the world today. Depression is much more common among women than men, with female/male risk ratios roughly 2:1. Aims: Recent epidemiological research is reviewed. Implications are suggested for needed future research. Results: The higher prevalence of depression among women than men is due to higher risk of first onset, not to differential persistence or recurrence. Although the gender difference first emerges in puberty. other experiences related to changes in sex hormones (pregnancy, menopause. use of oral contraceptives, and use of hormone replacement therapy) do not significantly influence major depression. These observations suggest that the key to understanding the higher rates of depression among women than men lies in an investigation of the joint effects of biological vulnerabilities and environmental provoking experiences. Conclusions: Advancing understanding of female depression will require future epidemiologic research to focus on first onsets and to follow incident cohorts of young people through the pubertal transition into young adulthood with fine-grained measures of both sex hormones and gender-related environmental experiences. Experimental interventions aimed at primary prevention by jointly manipulating putative biological and environmental risk factors will likely be needed to adjudicate between contending causal hypotheses regarding the separate and joint effects of interrelated risk factors. (C) 2002 Elsevier Science B.V. All rights reserved.