Purpose of review: In recent years, there has been an increased appreciation of gender and sex differences in mental illness. This perspective has included attention to sex differences in neurobiology, neurochemistry, sex steroids, endocrine sex reactivity and psychosocial stressors. However, emerging research investigating gene-environment interactions presents another layer of complexity in understanding sex differences in epidemiology, clinical features and treatment of mental disorders across the lifespan.
Recent findings: The main themes in the current literature point to gene-environment interactions underlying sex-specific differences in the psychiatric sequelae of both early childhood and current life stress. Evidence related to the serotonin-linked polymorphic region (5HTTLPR) polymorphism is strongest, but evidence exists for other candidate genes. There is also emerging support for genetic factors that increase susceptibility of some women to hormonal changes of the reproductive life cycle. The interaction of these genetic factors with various environmental stressors, many of which are more common in women, may increase the risk of mental illness, especially mood disorders.
Summary: Further research into sex-specific gene-environment interactions across the lifespan is needed with the goal of improving preventive efforts and optimizing treatment in women's mental health.