title: Sex differences in symptom patterns of recurrent major depression in siblings.
abstract: 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.
authors.affiliation: Department of Psychological Medicine, University of Wales College of Medicine, Cardiff, United Kingdom.
authors.forename: Valentina
authors.initials: V
authors.lastname: Moskvina
authors.forename: Anne
authors.initials: A
authors.lastname: Farmer
authors.forename: Ian Richard
authors.initials: IR
authors.lastname: Jones
authors.forename: Shyama
authors.initials: S
authors.lastname: Brewster
authors.forename: François
authors.initials: F
authors.lastname: Ferrero
authors.forename: Michael
authors.initials: M
authors.lastname: Gill
authors.forename: Lisa Anne
authors.initials: LA
authors.lastname: Jones
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Ole
authors.initials: O
authors.lastname: Mors
authors.forename: Mike J
authors.initials: MJ
authors.lastname: Owen
authors.forename: Julia
authors.initials: J
authors.lastname: Perry
authors.forename: Martin
authors.initials: M
authors.lastname: Preisig
authors.forename: Marcella
authors.initials: M
authors.lastname: Rietschel
authors.forename: Peter
authors.initials: P
authors.lastname: McGuffin
authors.forename: Nick
authors.initials: N
authors.lastname: Craddock
authors.forename: Ania
authors.initials: A
authors.lastname: Korszun
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000235:genetics* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment / Q000706:statistics & numerical data; D012008:Recurrence; D012737:Sex Factors; D035781:Siblings / Q000523:psychology*; D013223:Statistics as Topic