title: 5-HTTLPR and gender differences in affective disorders: A systematic review.
abstract: BACKGROUND
  Serotonin transporter-linked polymorphic region (5-HTTLPR) variants have been extensively studied in psychiatric disorders. Although gender effects have been reported, they have not been comprehensively reviewed. The aim of our study was to summarize literature findings on 5-HTTLPR and gender differences in affective disorders.
  
  
  METHODS
  A systematic search of PubMed, ISI Web of Knowledge, and PsycINFO databases was performed for dates until January 2015. The included articles (n=78) analyzed the association between 5-HTTLPR and affective spectrum disorders, taking into account gender. The quality of each study was assessed through STROBE and CONSORT.
  
  
  RESULTS
  5-HTTLPR modulation of affective disorders varied by gender. The S allele (or SS genotype) seemed to be differently associated with an increased risk of depression, depressive symptoms, anxiety traits and symptoms, and symptoms of internalizing behavior among women and an increased risk of aggressiveness, conduct disorder and symptom counts of externalizing behavior among men. Moreover, the presence of stressful life events reinforced the association. Interestingly, these differences seemed to begin with adolescence and were not consistent among the elderly, suggesting a plausible role of hormonal fluctuations.
  
  
  CONCLUSIONS
  The review is limited by the small number of included papers, due to the paucity of information in the literature regarding 5-HTTLPR and gender.
  
  
  CONCLUSIONS
  5-HTTLPR variants may exert a differential modulation on a number of features depending on gender. Further studies are needed to more deeply investigate the effect of 5-HTTLPR×gender on the modulation of affective disorders.
authors.affiliation: INSERM UMR 1178, Univ Paris Sud, Department of Psychiatry, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, 78 rue du Général Leclerc, 94275 Le Kremlin Bicêtre, France. Electronic address: florence.gressier@bct.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Gressier
authors.affiliation: INSERM U1061, University of Montpellier, FondaMental Foundation, Montpellier, France.
authors.forename: R
authors.initials: R
authors.lastname: Calati
authors.affiliation: Department of Biomedical and Neuromotor Science, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Serretti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000235:genetics*; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins
keywords: 5-HTTLPR; Affective disorders; Anxiety; Depression; Gender; Serotonin transporter; Stressful life events