The Role of Gender Factors Influencing Multiple Dimensions of Somatic Symptoms in Major Depressive Disorder Patients with Suicidal Ideation: Insights from the Chinese NSSD Study

Overview

Journal BMC Psychiatry

Publisher Biomed Central

Specialty Psychiatry

Date 2024 Oct 25

PMID 39456015

Authors

Ruizhi Mao

Jingjing Xu

Daihui Peng

Jun Chen

Zhiguo Wu

Yiru Fang

Affiliations

Soon will be listed here.

Abstract

Background: The study aimed to explore the influence of gender on the prevalence of various somatic symptoms and their associations with suicidal ideation (SI) among patients with major depressive disorder (MDD).

Methods: We recruited 3,275 patients with MDD from the National Survey on Symptomatology of Depression (NSSD), among whom 1,745 patients had SI. The clinical characteristics and the prevalence of somatic symptoms across 20 dimensions in MDD patients with SI were compared between male and female patients. Spearman correlation analysis and logistic regression analysis were used to explore the relationship between somatic symptoms and SI.

Results: In patients with SI, 32.2% of female participants attributed the onset of MDD to physical concerns, whereas 27% of male patients held a similar perspective (P = 0.032). Female patients exhibited a higher prevalence of early insomnia (64.6% vs. 70.2%) and a lower prevalence of hypersomnia (17.2% vs. 12.9%) and urinary system symptoms (25.0% vs. 17.8%). Logistic regression analysis indicated that female patients displayed a broader range of somatic symptoms identified as risk factors for SI, including increased appetite, respiratory symptoms, circulatory system symptoms, limb pain, and various others.

Conclusion: This study unveils gender-specific patterns in somatic symptoms among MDD patients with SI, highlighting the clinical significance of these symptoms in diagnosis and intervention. Understanding how physical concerns contribute to MDD, especially among females, underscores the need for tailored clinical approaches. Recognizing and addressing these symptoms could guide more effective suicide prevention strategies and enhance MDD management in clinical practice.

References

Sokero T, Melartin T, Rytsala H, Leskela U, Lestela-Mielonen P, Isometsa E . Suicidal ideation and attempts among psychiatric patients with major depressive disorder. J Clin Psychiatry. 2003; 64(9):1094-100. DOI: 10.4088/jcp.v64n0916. View

Shi J, Wang X, Zhao N, Kang C, Yang L, Zheng Y . Sex differences in residual somatic symptoms in patients with first-episode depression after acute-phase treatment. BMC Psychiatry. 2023; 23(1):119. PMC: 9948378. DOI: 10.1186/s12888-023-04612-3. View

Mills J, Thomas S, Larkin T, Pai N, Deng C . Problematic eating behaviours, changes in appetite, and weight gain in Major Depressive Disorder: The role of leptin. J Affect Disord. 2018; 240:137-145. DOI: 10.1016/j.jad.2018.07.069. View

Silverstein B . Gender differences in the prevalence of somatic versus pure depression: a replication. Am J Psychiatry. 2002; 159(6):1051-2. DOI: 10.1176/appi.ajp.159.6.1051. View

Fang X, Zhang C, Wu Z, Peng D, Xia W, Xu J . The association between somatic symptoms and suicidal ideation in Chinese first-episode major depressive disorder. J Affect Disord. 2018; 245:17-21. DOI: 10.1016/j.jad.2018.10.110. View

Dolsen E, Prather A, Lamers F, Penninx B . Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation. Psychol Med. 2020; 51(12):2094-2103. DOI: 10.1017/S0033291720000860. View

Stevens J, Schneider L, Husain A, Ito D, Fuller D, Zee P . Impairment in Functioning and Quality of Life in Patients with Idiopathic Hypersomnia: The Real World Idiopathic Hypersomnia Outcomes Study (ARISE). Nat Sci Sleep. 2023; 15:593-606. PMC: 10404411. DOI: 10.2147/NSS.S396641. View

Blais R, Monteith L, Kugler J . Sexual dysfunction is associated with suicidal ideation in female service members and veterans. J Affect Disord. 2017; 226:52-57. DOI: 10.1016/j.jad.2017.08.079. View

Morssinkhof M, van Wylick D, Priester-Vink S, van der Werf Y, den Heijer M, van den Heuvel O . Associations between sex hormones, sleep problems and depression: A systematic review. Neurosci Biobehav Rev. 2020; 118:669-680. DOI: 10.1016/j.neubiorev.2020.08.006. View

10.

Dolsen E, Crosswell A, Prather A . Links Between Stress, Sleep, and Inflammation: Are there Sex Differences?. Curr Psychiatry Rep. 2019; 21(2):8. PMC: 6426453. DOI: 10.1007/s11920-019-0993-4. View

11.

Asselmann E, Kische H, Haring R, Hertel J, Schmidt C, Nauck M . Prospective associations of androgens and sex hormone-binding globulin with 12-month, lifetime and incident anxiety and depressive disorders in men and women from the general population. J Affect Disord. 2019; 245:905-911. DOI: 10.1016/j.jad.2018.11.052. View

12.

Hwang W, Lee T, Kim N, Kwon J . The Role of Estrogen Receptors and Their Signaling across Psychiatric Disorders. Int J Mol Sci. 2021; 22(1). PMC: 7794990. DOI: 10.3390/ijms22010373. View

13.

Ryu K, Park H, Jeong Y, Nam S, Jeong H, Kim T . Age at Menopause and Suicidal Ideation in Menopausal Women: A Study of Korea National Health and Nutrition Examination Survey Data. J Korean Med Sci. 2022; 37(45):e330. PMC: 9678656. DOI: 10.3346/jkms.2022.37.e330. View

14.

Martin S, Tully P, Kahokehr A, Jay A, Wittert G . The bidirectional association between depression and lower urinary tract symptoms (LUTS) in men: A systematic review and meta-analysis of observational studies. Neurourol Urodyn. 2022; 41(2):552-561. DOI: 10.1002/nau.24868. View

15.

Wu Y, Tao Z, Qiao Y, Chai Y, Liu Q, Lu Q . Prevalence and characteristics of somatic symptom disorder in the elderly in a community-based population: a large-scale cross-sectional study in China. BMC Psychiatry. 2022; 22(1):257. PMC: 9004132. DOI: 10.1186/s12888-022-03907-1. View

16.

Zitouni M, Oh S, Vicnesh J, Khandoker A, Rajendra Acharya U . Automated recognition of major depressive disorder from cardiovascular and respiratory physiological signals. Front Psychiatry. 2022; 13:970993. PMC: 9780587. DOI: 10.3389/fpsyt.2022.970993. View

17.

Petrovsky D, Hirschman K, Varrasse McPhillips M, Sefcik J, Hanlon A, Huang L . Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports. Int Psychogeriatr. 2020; 32(7):849-861. PMC: 7455051. DOI: 10.1017/S1041610220000782. View

18.

Kohn J, Cabrera Y, Dimitrov S, Guay-Ross N, Pruitt C, Shaikh F . Sex-specific roles of cellular inflammation and cardiometabolism in obesity-associated depressive symptomatology. Int J Obes (Lond). 2019; 43(10):2045-2056. PMC: 6774832. DOI: 10.1038/s41366-019-0375-3. View

19.

Zuluaga L, Caicedo J, Mogollon M, Santander J, Bravo-Balado A, Trujillo C . Anxiety and depression in association with lower urinary tract symptoms: results from the COBaLT study. World J Urol. 2023; 41(5):1381-1388. DOI: 10.1007/s00345-023-04351-w. View

20.

Bertele N, Wendling C, Reinken V, Gross J, Talmon A . Somatic symptom profiles are associated with pre-treatment depression and anxiety symptom severity but not inpatient therapy outcomes. Psychother Res. 2022; 33(2):211-221. DOI: 10.1080/10503307.2022.2090870. View