Major depressive disorder in a community-based twin sample -: Are there different genetic and environmental contributions for men and women?
Major depressive disorder in a community-based twin sample -: Are there different genetic and environmental contributions for men and women?
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DOI：
10.1001/archpsyc.56.6.557
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发表时间：
1999-06-01
影响因子：
--
通讯作者：
Martin, NG
中科院分区：
文献类型：
--
作者：
Bierut, LJ;Heath, AC;Martin, NG
背景：抑郁症对女性的影响大于男性，并且经常在家庭中聚集。通过以社区为基础的双胞胎样本，我们研究了遗传和环境因素对患重度抑郁症风险的影响，以及性别和抑郁症的不同定义对遗传和环境影响的相对影响。基因效应的性别差异也被研究。方法：对澳大利亚双胞胎志愿者样本（2662对）进行了访谈，访谈采用了酒精中毒遗传学半结构化评估的简化版本，这是一种旨在评估精神疾病的半结构化访谈。抑郁症的定义采用3种不同的标准集：DSM-III-R重度抑郁症、DSM-IV重度抑郁症和DSM-IV重度抑郁症。利用遗传模型拟合估计了遗传和环境因素对患抑郁症的影响。结果：DSM-III-R型重性抑郁症的终生患病率为女性31%，男性24%，DSM-IV型重性抑郁症的终生患病率为女性22%，男性16%，重度DSM-IV型重性抑郁症的终生患病率为女性9%，男性3%。在女性中，最简单的适合数据的模型涉及抑郁症发展中个体特有的遗传因素和环境因素，遗传率估计在36%到44%之间。在男性中，抑郁症只有轻微的家族性，因此个体环境因素在抑郁症的发展中起着更大的作用。对于DSM-III-R重度抑郁症，男性和女性的遗传率估计在统计学上存在差异。对于两性而言，使用不同的抑郁定义，遗传和环境因素的相对贡献是稳定的。结论：女性抑郁症存在中度家族聚集性，这主要归因于遗传因素。在男性中，只有适度的抑郁症家族聚集性。对于男性和女性来说，个人环境经历在抑郁症的发展中都起着很大的作用。根据DSM-III-R定义的重度抑郁症，女性比男性更易遗传。对于从广义到狭义的不同抑郁症定义，遗传和环境因素对抑郁症发展的相对贡献是相似的。
Background: Depression affects more women than men and often aggregates in families. Using a community-based sample of twins, we examined the contributions of genetic and environmental factors to the risk of developing major depressive disorder and the effect of sex and different definitions of depression on the relative contributions of genetic and environmental effects. Sex differences in genetic effects were also studied.Methods: A volunteer sample of Australian twins (2662 pairs) was interviewed using an abbreviated version of the Semi-Structured Assessment for the Genetics of Alcoholism, a semi-structured lay interview designed to assess psychiatric disorders. Depression was defined using 3 different criteria sets: DSM-III-R major depressive disorder, DSM-IV major depressive disorder, and severe DSM-IV major depressive disorder. Genetic and environmental contributions to the liability to develop depression were estimated using genetic model fitting.Results: Lifetime prevalences were 31% in women and 24% in men for DSM-III-R major depressive disorder, 22% in women and 16% in men for DSM-IV major depressive disorder, and 9% in women and 3% in men for severe DSM-IV major depressive disorder. In women, the simplest model to fit the data implicated genetic factors and environmental factors unique to the individual in the development of depression, with heritability estimates ranging from 36% to 44%. In men, depression was only modestly familial, and thus individual environmental factors played a larger role in the development of depression. For DSM-III-R major depressive disorder, there were statistically different estimates for heritability for men vs women. For both sexes, the relative contributions of genetic and environmental factors were stable using different definitions of depression.Conclusions: There was moderate familial aggregation of depression in women and this primarily was attributable to genetic factors. In men, there was only modest familial aggregation of depression. For both men and women, individual environmental experiences played a large role in the development of depression. Major depressive disorder as defined by DSM-III-R was more heritable in women as compared with men. The relative contributions of genetic and environmental factors in the development of depression were similar for varying definitions of depression, from a broad definition to a narrow definition.