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United we stand stronger: Overcoming the discrepancy in depression research and treatment between the sexes; insight from interpersonal, pharmacological and neuro-endocrinological research

Eldering, AA. (2016) United we stand stronger: Overcoming the discrepancy in depression research and treatment between the sexes; insight from interpersonal, pharmacological and neuro-endocrinological research. Bachelor's Thesis, Biology.

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Abstract

Depression is considered to be the second leading cause in disability in the world (Ferrari et al, 2013), affecting 121 million people worldwide (Mechiel-Korte et al, 2015). Depression is a debilitating disease that incapacitates patients and is hard to treat, even the addition of antidepressants to treatment is effective as often as it is not (Nemeroff et al., 2007). Additionally, the occurrence of depression is twice as high in women as compared to men, a significant difference that is not well understood and underrepresented in research (Guttierrez-Lobos et al., 2002). For both men and women depression usually develops at the same developmental stage, adolescence (Kessler et al., 2005). But while the rate of depression increases for both sexes, the gender difference becomes apparent, more girls than boys display depressive symptoms (Angold et al., 1998). Not only is this the case, there are also a lot of intersexual differences in the treatment of depression with antidepressants. Although it is not clear where the differences come from, there are implications in research about; 1. Developmental and symptomatological intersexual differences; 2. Neuro-endocrinology, namely differences in the HPA-axis and the hippocampus and their response to stress; 3. Gender specific hormones, both estrogen and testosterone seem to play an integral part; 4. Pharmacokinetics, all parts of the ADME spectrum. This article attempts to combine the research of these intersexual differences that can influence the efficacy of antidepressant treatment and the prevalence of depression and concludes that: firstly, antidepressive treatment and antidepressants leave a lot of room for improvement, the group that seems to suffer from this fact the most are women. They have been underrepresented in depression research for a long time, while they are overrepresented in cases of depression. Secondly, that the role of gonadal hormones, with in particular estrogen, is hugely important, nevertheless gonadal hormones do not explain the discrepancy on their own. A comprehensive study, which uses genomic, hormonal and cultural data is probably needed to unravel this problem. Finally, considering the importance of depression as a disease in our current day and age, all research is sorely needed. Researching pharmacokinetic, personal and physiological differences between men and women will benefit both groups. With the work that has already been done in these subjects, a lot of improvements in treatment already seem possible. It’s important that current and future research is quickly translated into clinical research and eventually, treatment. Which hopefully can be personalized one day, so we can leave a lot of the adverse effects behind us.

Item Type: Thesis (Bachelor's Thesis)
Degree programme: Biology
Thesis type: Bachelor's Thesis
Language: English
Date Deposited: 15 Feb 2018 08:26
Last Modified: 15 Feb 2018 08:26
URI: http://fse.studenttheses.ub.rug.nl/id/eprint/14718

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