Neurobiological Aspect of Sex Difference in Stress-related Mental Disorders

背景：某些精神疾病之罹病率存在顯著性別差異，且壓力事件之嚴重度與精神疾病之穩定度有關。我們回顧文獻著重壓力調適之性別差異及其神經生物學可能之變化，從四方面探討包括：下視丘、腦下腺及腎上腺軸(HPA axis)，中樞之單胺類，女性荷爾蒙及各腦區。結果：其結果如下：(A)於創傷後壓力症候群患者中HPA axis之皮質醇低下之變化以女性居多。日常生活壓力較會影響健康女性之皮質醇。(B)腎上腺素對健康女性壓力下記憶形成影響較顯著。健康女性其血清激素較易受生活壓力變化之影響，而健康男性之多巴胺較易受生活壓力變化之影響。(C)在壓力下女性荷爾蒙對個體具神經保護機制。(D)杏仁核及胼胝體受壓力影響而具性別差異。然而目前有關性別對壓力因應影響之神經生物學研究仍不足。結論：未來需發展更多結合生物及心理及社會學上之解釋模式進行研究。

關鍵字

性別差異；因應壓力；精神疾病

並列摘要

Background: The sex differences in mental disorders have attracted the attention of researchers. Although the exact sex ratio female to male of prevalence in major depressive disorder varies slightly from culture to culture, most nations have reported a sex ratio close to 2:1. A reverse correlation has been found between the severity of life events and stability of mental disorders. Method: We did the literature review for English papers. This review included four major biological perspectives: (A) the hypothalamic-pituitary-adrenal (HPA) axis, (B) the monoamines in the CNS, (C) the sex hormones and (D) the cerebral regions. Results: The review showed (A) The HPA axis is known to be sensitive to mental illness. But, the HPA axis function, as indicated by plasma cortisol levels, varies in patients with post-traumatic stress disorders (PTSD). Only the PTSD female patients have been found to have low cortisol levels. In addition, the healthy females have higher cortical levels in response to daily stress. (B) Noradrenalin (epinephrine) plays a role in memory consolidation in coping with stress, particularly in females. Higher serotonin transporter availability in response to daily stress is also observed in females. In contrast, males' dopamine transporter availability is more vulnerable to daily life stress. (C) Estrogen can protect animals and human from stress. (D) Prominent anatomical differences exist in the amygdala and corpus callosum between the two sexes when under stress. Conclusion: Currently, the research of sex differences in stress coping is inadequate. We suggest that the integrating biologic and psychosocial vulnerabilities is an exciting topic for future research, and that a conceptual framework or testable hypothesis to embrace all pathogenesis for the sex differences in stress-coping is needed.

並列關鍵字

sex differences ； stress coping ； mental disorder

參考文獻

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