Influence of sex and stress exposure across the lifespan on endophenotypes of depression: focus on behavior, glucocorticoids and hippocampus

Abstract

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Sex differences exist in vulnerability, symptoms and treatment of many neuropsychiatric disorders. In this review we discuss both preclinical and clinical research that investigates how sex influences depression endophenotypes at the behavioral, neuroendocrine, and neural levels across the lifespan. Chronic exposure to stress is a risk factor for depression and we discuss how stress during the prenatal, postnatal, and adolescent periods differentially affects males and females depending on the method of stress and metric examined. Given that the integrity of the hippocampus is compromised in depression, we specifically focus on sex differences in how hippocampal plasticity is affected by stress and depression across the lifespan. In addition, we examine how female physiology predisposes depression in adulthood, specifically in postpartum and perimenopausal periods. Finally, we discuss the underrepresentation of women in both preclinical and clinical research and how this limits our understanding of sex differences in vulnerability, presentation, and treatment of depression.

Keywords

• Depression
• adolescence
• HPA axis
• sex differences
• Hippocampal neurogenesis