PDF(Pubmed)
Abstract：
BACKGROUND: Major depressive disorder (MDD) is a highly prevalent mental health disorder with females experiencing higher rates of depression (11.6%), anxiety (15.7%) and physiological distress (14.5%) than males. Recently, the Endocannabinoid system (ECS) has been proposed to be a key contributing factor in the pathogenesis and symptom severity of MDD due to its role in neurotransmitter production, inflammatory response and even regulation of the female reproductive cycle. This review critically evaluates evidence regarding ECS levels in female-sexed individuals with depressive disorders to further understand ECS role.
METHODS: A systematic literature review of available research published prior to April 2022 was identified using PubMed (U.S. National Library of Medicine), CINAHL (EBSCO), Web of Science, AMED and Scopus (Elsevier). Studies were included if they reported ECS analysis of female-sexed individuals with depression and were excluded if they did not differentiate results between sexes, assessed mental health conditions other than depression, tested efficacy of endocannabinoid/n-acylethanolamine/cannabis or marijuana administration and that were unable to be translated. Critical appraisal of each included study was undertaken using the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews.
RESULTS: The 894 located citations were screened for duplicates (n = 357) and eligibility by title and abstract (n = 501). The full text of 33 studies were reviewed, and 7 studies were determined eligible for inclusion. These studies indicated that depressed female-sexed individuals have altered levels of ECS however no significant pattern was identified due to variability of study outcomes and measures, limiting overall interpretation.
CONCLUSIONS: This review suggests potential involvement of ECS in underlying mechanisms of MDD in female sexed-individuals, however no pattern was able to be determined. A major contributor to the inability to attain reliable and valid understanding of the ECS levels in female-sexed individuals with depression was the inconsistency of depression screening tools, inclusion criteria\'s and analysis methods used to measure eCBs. Future studies need to implement more standardised methodology to gain a deeper understanding of ECS in female-sexed individuals with depressive disorders. TRIAL REGISTRATION : This review was submitted to PROSPERO for approval in April 2022 (Registration #CRD42022324212).
METHODS: A systematic literature review of available research published prior to April 2022 was identified using PubMed (U.S. National Library of Medicine), CINAHL (EBSCO), Web of Science, AMED and Scopus (Elsevier). Studies were included if they reported ECS analysis of female-sexed individuals with depression and were excluded if they did not differentiate results between sexes, assessed mental health conditions other than depression, tested efficacy of endocannabinoid/n-acylethanolamine/cannabis or marijuana administration and that were unable to be translated. Critical appraisal of each included study was undertaken using the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews.
RESULTS: The 894 located citations were screened for duplicates (n = 357) and eligibility by title and abstract (n = 501). The full text of 33 studies were reviewed, and 7 studies were determined eligible for inclusion. These studies indicated that depressed female-sexed individuals have altered levels of ECS however no significant pattern was identified due to variability of study outcomes and measures, limiting overall interpretation.
CONCLUSIONS: This review suggests potential involvement of ECS in underlying mechanisms of MDD in female sexed-individuals, however no pattern was able to be determined. A major contributor to the inability to attain reliable and valid understanding of the ECS levels in female-sexed individuals with depression was the inconsistency of depression screening tools, inclusion criteria\'s and analysis methods used to measure eCBs. Future studies need to implement more standardised methodology to gain a deeper understanding of ECS in female-sexed individuals with depressive disorders. TRIAL REGISTRATION : This review was submitted to PROSPERO for approval in April 2022 (Registration #CRD42022324212).
摘要：
背景：重度抑郁障碍（MDD）是一种非常普遍的心理健康障碍，女性的抑郁症发生率更高（11.6％），焦虑(15.7%)和生理困扰(14.5%)高于男性。最近,内源性大麻素系统（ECS）由于其在神经递质产生中的作用，已被认为是MDD发病机理和症状严重程度的关键促成因素，炎症反应甚至调节女性生殖周期。这篇评论严格评估了有关患有抑郁症的女性性别个体中ECS水平的证据，以进一步了解ECS的作用。
方法：使用PubMed（美国国家医学图书馆）对2022年4月之前发表的可用研究进行了系统文献综述，CINAHL(EBSCO)，WebofScience,AMED和Scopus（Elsevier）。如果他们报告了对患有抑郁症的女性性别个体的ECS分析，则包括研究，如果他们没有区分性别的结果，则将其排除在外。评估抑郁症以外的心理健康状况，测试了内源性大麻素/正酰基乙醇胺/大麻或大麻给药的疗效，但无法翻译。使用JoannaBriggsInstitute关键评估工具进行系统评估，对每项纳入的研究进行关键评估。
结果：通过标题和摘要（n=501）筛选了894个定位引文的重复（n=357）和合格性。对33项研究的全文进行了综述，7项研究被确定符合纳入条件.这些研究表明，抑郁的女性性别个体改变了ECS的水平，但是由于研究结果和措施的可变性，没有发现明显的模式。限制整体解释。
结论：本综述提示ECS可能参与女性性别个体MDD的潜在机制，然而，没有模式能够确定。无法获得可靠和有效的了解女性抑郁个体ECS水平的主要原因是抑郁筛查工具的不一致。用于测量eCBs的纳入标准和分析方法。未来的研究需要实施更标准化的方法，以更深入地了解患有抑郁症的女性性别个体的ECS。试验注册：该审查于2022年4月提交给PROSPERO批准（注册编号CRD42022324212）。
方法：使用PubMed（美国国家医学图书馆）对2022年4月之前发表的可用研究进行了系统文献综述，CINAHL(EBSCO)，WebofScience,AMED和Scopus（Elsevier）。如果他们报告了对患有抑郁症的女性性别个体的ECS分析，则包括研究，如果他们没有区分性别的结果，则将其排除在外。评估抑郁症以外的心理健康状况，测试了内源性大麻素/正酰基乙醇胺/大麻或大麻给药的疗效，但无法翻译。使用JoannaBriggsInstitute关键评估工具进行系统评估，对每项纳入的研究进行关键评估。
结果：通过标题和摘要（n=501）筛选了894个定位引文的重复（n=357）和合格性。对33项研究的全文进行了综述，7项研究被确定符合纳入条件.这些研究表明，抑郁的女性性别个体改变了ECS的水平，但是由于研究结果和措施的可变性，没有发现明显的模式。限制整体解释。
结论：本综述提示ECS可能参与女性性别个体MDD的潜在机制，然而，没有模式能够确定。无法获得可靠和有效的了解女性抑郁个体ECS水平的主要原因是抑郁筛查工具的不一致。用于测量eCBs的纳入标准和分析方法。未来的研究需要实施更标准化的方法，以更深入地了解患有抑郁症的女性性别个体的ECS。试验注册：该审查于2022年4月提交给PROSPERO批准（注册编号CRD42022324212）。
