성별에 따른 우울증 양상과 신경전달물질의 차이
Gender Differences in the Clinical Manifestation of Depression and Related Neurotransmitters
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Depression is almost twice as prevalent in women than men. Atypical symptoms, somatic complaints, and comorbid anxiety disorders are more common in women, whereas suicide and comorbid substance use disorders are more common in men. Previous studies have also reported gender differences in the efficacy of and tolerability to specific classes of antidepressants. Various psychosocial and biological factors have been proposed to explain the gender differences in clinical characteristics of depression. The predominant theory of depression pathogenesis is the monoamine hypothesis, and consequently, monoamine neurotransmitters have been the primary target of antidepressants. In the first section of this review, study findings of clinical differences in depression by gender are summarized. Then, we provide an overview of the findings from human and rodent studies of gender differences in serotonin, norepinephrine, dopamine, and glutamate neurotransmitter systems. Total level, rate of synthesis, and receptor profiles of neurotransmitters seem to differ by gender in the euthymic state, depressed state, and in responses to stress or antidepressants. Furthermore, these neurotransmitters interact with gonadal hormones and the hypothalamic-pituitaryadrenal axis, systems that innately exhibit gender differences. Although most of the studies conducted so far are limited to animal models and results of the studies are heterogeneous, growing evidence suggests that gender differences exist in neurotransmitter systems, which possibly leads to gender differences in depression. More intensive studies in this field are needed to build gender-specific treatment strategies.
Abstract
Depression is almost twice as prevalent in women than men. Atypical symptoms, somatic complaints, and comorbid anxiety disorders are more common in women, whereas suicide and comorbid substance use disorders are more common in men. Previous studies have also reported gender differences in the efficacy of and tolerability to specific classes of antidepressants. Various psychosocial and biological factors have been proposed to explain the gender differences in clinical characteristics of depression. The predominant theory of depression pathogenesis is the monoamine hypothesis, and consequently, monoamine neurotransmitters have been the primary target of antidepressants. In the first section of this review, study findings of clinical differences in depression by gender are summarized. Then, we provide an overview of the findings from human and rodent studies of gender differences in serotonin, norepinephrine, dopamine, and glutamate neurotransmitter systems. Total level, rate of synthesis, and receptor profiles of neurotransmitters seem to differ by gender in the euthymic state, depressed state, and in responses to stress or antidepressants. Furthermore, these neurotransmitters interact with gonadal hormones and the hypothalamic-pituitaryadrenal axis, systems that innately exhibit gender differences. Although most of the studies conducted so far are limited to animal models and results of the studies are heterogeneous, growing evidence suggests that gender differences exist in neurotransmitter systems, which possibly leads to gender differences in depression. More intensive studies in this field are needed to build gender-specific treatment strategies.
참고문헌 (61)
- "Global health estimates 2016 summary tables: DALYs by cause, age and sex, by world bank income group, 2000-2016" (2018)[URL]
- Seedat S, "Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys", Arch Gen Psychiatry, 66, pp.785~795 (2009)
- Kessler RC, "Sex and depression in the national comorbidity survey. I: lifetime prevalence, chronicity and recurrence", J Affect Disord, 29, pp.85~96 (1993)
- Weissman MM, "Sex differences in rates of depression : cross-national perspectives", J Affect Disord, 29, pp.77~84 (1993)
- "2011년 정신질환 실태 역학조사 결과발표" (2012), 보건복지부 정신건강정책과[URL]
- Angold A, "Puberty and depression: the roles of age, pubertal status and pubertal timing", Psychol Med, 28, pp.51~61 (1998)
- Wang H, "Age at onset of puberty and adolescent depression: “Children of 1997”Birth Cohort", Pediatrics, 137, pp.e20153231~ (2016)
- Skoog T, "Understanding the link between pubertal timing in girls and the development of depressive symptoms : The role of sexual harassment", J Youth Adolesc, 45, pp.316~327 (2016)
- Conley CS, "Explaining the longitudinal association between puberty and depression : sex differences in the mediating effects of peer stress", Dev Psychopathol, 24, pp.691~701 (2012)
- Angold A, "Puberty and depression", Child Adolesc Psychiatr Clin N Am, 15, pp.919~937 (2006)[DOI]
- Nolen-Hoeksema S, "Explaining the gender difference in depressive symptoms", J Pers Soc Psychol, 77, pp.1061~1072 (1999)
- Maier W, "Gender differences in the prevalence of depression : a survey in primary care", J Affect Disord, 53, pp.241~252 (1999)
- Piccinelli M, "Gender differences in depression. Critical review", Br J Psychiatry, 177, pp.486~492 (2000)
- Campbell JC, "Health consequences of intimate partner violence", Lancet, 359, pp.1331~1336 (2002)
- Nolen-Hoeksema S, "Gender differences in depression", Curr Dir Psychol Sci, 10, pp.173~176 (2001)
- Singh T, "Atypical depression", Psychiatry(Edgmont), 3, pp.33~39 (2006)
- 김지현, "Gender Differences in Depressive Symptom Profile: Results from Nationwide General Population Surveys in Korea", Journal of Korean Medical Science, 30(11), pp.1659~1666 (2015), 대한의학회
- Diekstra RF, "The epidemiology of suicidal behaviour : a review of three continents", World Health Stat Q, 46, pp.52~68 (1993)
- "2015년 사망원인통계" (2016), 사회통계부 인구동향과[URL]
- Marcus SM, "Gender differences in depression : findings from the STAR*D study", J Affect Disord, 87, pp.141~150 (2005)
- Drossman DA, "Sexual and physical abuse and gastrointestinal illness. Review and recommendations", Ann Intern Med, 123, pp.782~794 (1995)
- McCauley J, "The"battering syndrome" : prevalence and clinical characteristics of domestic violence in primary care internal medicine practices", Ann Intern Med, 123, pp.737~746 (1995)
- Schuch JJ, "Gender differences in major depressive disorder : results from the Netherlands study of depression and anxiety", J Affect Disord, 156, pp.156~163 (2014)
- Haug TT, "The association between anxiety, depression, and somatic symptoms in a large population: the HUNT-II study", Psychosom Med, 66, pp.845~851 (2004)
- De Leo D, "Lifetime risk of suicide ideation and attempts in an Australian community:prevalence, suicidal process, and help-seeking behaviour", J Affect Disord, 86, pp.215~224 (2005)
- Sagud M, "Gender differences in depression", Coll Antropol, 26, pp.149~157 (2002)
- Baca E, "Gender differences in treatment response to sertraline versus imipramine in patients with nonmelancholic depressive disorders", Prog Neuropsychopharmacol Biol Psychiatry, 28, pp.57~65 (2004)
- Thase ME, "Relative antidepressant efficacy of venlafaxine and SSRIs : sex-age interactions", J Womens Health(Larchmt), 14, pp.609~616 (2005)
- Young EA, "Sex differences in response to citalopram : a STAR*D report", J Psychiatr Res, 43, pp.503~511 (2009)
- Hildebrandt MG, "Are gender differences important for the clinical effects of antidepressants?", Am J Psychiatry, 160, pp.1643~1650 (2003)
- Quitkin FM, "Are there differences between women’s and men’s antidepressant responses?", Am J Psychiatry, 159, pp.1848~1854 (2002)
- Nishizawa S, "Differences between males and females in rates of serotonin synthesis in human brain", Proc Natl Acad Sci U S A, 94, pp.5308~5313 (1997)
- Young SN, "Tryptophan, 5-hydroxyindoleacetic acid and indoleacetic acid in human cerebrospinal fluid: interrelationships and the influence of age, sex, epilepsy and anticonvulsant drugs", J Neurol Neurosurg Psychiatry, 43, pp.438~445 (1980)
- Gressier F, "5-HTTLPR and gender differences in affective disorders : A systematic review", J Affec Disord, 190, pp.193~207 (2016)
- Hou C, "CSF serotonin, 5-hydroxyindolacetic acid and neuropeptide Y levels in severe major depressive disorder", Brain Res, 1095, pp.154~158 (2006)
- beta-CIT SPECT measures of dopamine and serotonin transporter availability in healthy smokers and nonsmokers, "Synapse", 2001, 275~284
- Jovanovic H, "Sex differences in the serotonin 1A receptor and serotonin transporter binding in the human brain measured by PET", Neuroimage, 39, pp.1408~1419 (2008)
- Biver F, "Sex difference in 5HT2 receptor in the living human brain", Neurosci Lett, 204, pp.25~28 (1996)
- Booij L, "Predictors of mood response to acute tryptophan depletion. A reanalysis", Neuropsychopharmacology, 27, pp.852~861 (2002)
- Ellenbogen MA, "Mood response to acute tryptophan depletion in healthy volunteers : sex differences and temporal stability", Neuropsychopharmacology, 15, pp.465~474 (1996)
- Staley JK, "Sex Differences in Diencephalon Serotonin Transporter Availability in Major Depression", Biol Psychiatry, 59, pp.40~47 (2006)
- Gressier F, "5-HTTLPR and gender differences in affective disorders : A systematic review", J Affect Disord, 190, pp.193~207 (2016)
- Dalla C, "Sex differences in animal models of depression and antidepressant response", Basic Clin Pharmacol Toxicol, 106, pp.226~233 (2010)
- Pitychoutis PM, "Papadopoulou-Daifoti Z. 5-HT(1A), 5-HT(2A), and 5-HT(2C)receptor mRNA modulation by antidepressant treatment in the chronic mild stress model of depression: sex differences exposed", Neuroscience, 210, pp.152~167 (2012)
- Kokras N, "Sex differences in animal models of psychiatric disorders", Br J Pharmacol, 171, pp.4595~4619 (2014)
- Pinos H, "The development of sex differences in the locus coeruleus of the rat", Brain Res Bull, 56, pp.73~78 (2001)
- Bangasser DA, "Sexual dimorphism in locus coeruleus dendritic morphology : a structural basis for sex differences in emotional arousal", Physiol Behav, 103, pp.342~351 (2011)
- Curtis AL, "Sexually dimorphic responses of the brain norepinephrine system to stress and corticotropin-releasing factor", Neuropsychopharmacology, 31, pp.544~554 (2006)
- Bangasser DA, "Sex differences in corticotropin-releasing factor receptor signaling and trafficking : potential role in female vulnerability to stress-related psychopathology", Mol Psychiatry, 15, pp.877~ (2010)[DOI]
- Schwabe L, "Opposite effects of noradrenergic arousal on amygdala processing of fearful faces in men and women", Neuroimage, 73, pp.1~7 (2013)
- Bangasser DA, "Sex differences in the locus coeruleus-norepinephrine system and its regulation by stress", Brain Res, 1641, pp.177~188 (2016)
- fallypride in striatal and extrastriatal regions : A PET study, "Am J Psychiatry", 2006, 1639~1641
- Munro CA, "Sex differences in striatal dopamine release in healthy adults", Biol Psychiatry, 59, pp.966~974 (2006)
- Kuhn C, "The emergence of gonadal hormone influences on dopaminergic function during puberty", Horm Behav, 58, pp.122~137 (2010)
- Campi KL, "Sex differences in effects of dopamine D1receptors on social withdrawal", Neuropharmacology, 77, pp.208~216 (2014)
- Hodes GE, "Sex differences in nucleus accumbens transcriptome profiles associated with susceptibility versus resilience to subchronic variable stress", J Neurosci, 35, pp.16362~16376 (2015)
- Gray AL, "Sex differences in glutamate receptor gene expression in major depression and suicide", Mol Psychiatry, 20, pp.1057~1068 (2015)
- Wang Y, "Prenatal chronic mild stress induces depression-like behavior and sex-specific changes in regional glutamate receptor expression patterns in adult rats", Neuroscience, 301, pp.363~374 (2015)
- Sarkar A, "Sex differences in effects of ketamine on behavior, spine density, and synaptic proteins in socially isolated rats", Biol Psychiatry, 80, pp.448~456 (2016)
- Lokuge S, "Depression in women: windows of vulnerability and new insights into the link between estrogen and serotonin", J Clin Psychiatry, 72, pp.e1563~e1569 (2011)
- Goel N, "Sex differences in serotonin(5-HT)1A receptor regulation of HPA axis and dorsal raphe responses to acute restraint", Psychoneuroendocrinology, 40, pp.232~241 (2014)