Gender differences in depression. Critical review.

BACKGROUND With few exceptions, the prevalence, incidence and morbidity risk of depressive disorders are higher in females than in males, beginning at mid-puberty and persisting through adult life. AIMS To review putative risk factors leading to gender differences in depressive disorders. METHOD A critical review of the literature, dealing separately with artefactual and genuine determinants of gender differences in depressive disorders. RESULTS Although artefactual determinants may enhance a female preponderance to some extent, gender differences in depressive disorders are genuine. At present, adverse experiences in childhood, depression and anxiety disorders in childhood and adolescence, sociocultural roles with related adverse experiences, and psychological attributes related to vulnerability to life events and coping skills are likely to be involved. Genetic and biological factors and poor social support, however, have few or no effects in the emergence of gender differences. CONCLUSIONS Determinants of gender differences in depressive disorders are far from being established and their combination into integrated aetiological models continues to be lacking.

[1]  M. Weissman,et al.  Sex differences and the epidemiology of depression. , 1977, Archives of general psychiatry.

[2]  J. Egeland,et al.  Amish Study, I: Affective disorders among the Amish, 1976-1980. , 1983, The American journal of psychiatry.

[3]  G. Klerman,et al.  Sex-related differences in depression. Familial evidence. , 1984, Journal of affective disorders.

[4]  J. Angst,et al.  Do the diagnostic criteria determine the sex ratio in depression? , 1984, Journal of affective disorders.

[5]  R. Jenkins.  Sex differences in minor psychiatric morbidity. , 1985, Psychological medicine. Monograph supplement.

[6]  K. Merikangas,et al.  Genetic factors in the sex ratio of major depression , 1985, Psychological Medicine.

[7]  M. Dew,et al.  Long-term reliability of diagnosing lifetime major depression in a community sample. , 1986, Archives of general psychiatry.

[8]  S. Faraone,et al.  Sex differences in affective disorder: Genetic transmission , 1987, Genetic epidemiology.

[9]  S. Nolen-Hoeksema,et al.  Sex Differences in Unipolar Depression: Evidence and Theory Background on the Affective Disorders , 1987 .

[10]  J. Vázquez-Barquero,et al.  A community mental health survey in Cantabria: a general description of morbidity , 1987, Psychological Medicine.

[11]  M. Tousignant,et al.  Sex biases in mental health scales: do women tend to report less serious symptoms and confide more than men? , 1987, Psychological Medicine.

[12]  P. McGuffin,et al.  The Camberwell Collaborative Depression Study III. Depression and Adversity in the Relatives of Depressed Probands , 1988, British Journal of Psychiatry.

[13]  D. Kupfer,et al.  Sex differences in recurrent depression: are there any that are significant? , 1988, The American journal of psychiatry.

[14]  A. Beck,et al.  Sex differences on the revised Beck Depression Inventory for outpatients with affective disorders. , 1989, Journal of personality assessment.

[15]  L. Robins,et al.  The Validity of psychiatric diagnosis , 1989 .

[16]  B. Dohrenwend.  ‘The problem of validity in field studies of psychological disorders’revisited , 1990, Psychological Medicine.

[17]  M A Young,et al.  Gender Differences in the Clinical Features of Unipolar Major Depressive Disorder , 1990, The Journal of nervous and mental disease.

[18]  Social networks and support , 1990 .

[19]  W. Coryell,et al.  Major depression in a nonclinical sample. Demographic and clinical risk factors for first onset. , 1992, Archives of general psychiatry.

[20]  Social support, depressed mood, and adjustment to stress: a genetic epidemiologic investigation. , 1992 .

[21]  J. Wurtman.  Depression and weight gain: the serotonin connection. , 1993, Journal of affective disorders.

[22]  R. Kessler,et al.  The prediction of major depression in women: toward an integrated etiologic model. , 1993, The American journal of psychiatry.

[23]  L. Lumley,et al.  The multiple interactional biological processes that might lead to depression and gender differences in its appearance. , 1993, Journal of affective disorders.

[24]  R. Kessler,et al.  Sex and depression in the National Comorbidity Survey. I: Lifetime prevalence, chronicity and recurrence. , 1993, Journal of affective disorders.

[25]  W. Heller,et al.  Gender differences in depression: perspectives from neuropsychology. , 1993, Journal of affective disorders.

[26]  B. Given,et al.  Gender bias in the measurement properties of the center for epidemiologic studies depression scale (CES-D) , 1993, Psychiatry Research.

[27]  B. Rodgers.  Pathways between parental divorce and adult depression. , 1994, Journal of child psychology and psychiatry, and allied disciplines.

[28]  K. Wilhelm,et al.  Sex differences in lifetime depression rates: fact or artefact? , 1994, Psychological Medicine.

[29]  J. Schwartz,et al.  Are diagnostic criteria, time of episode and occupational impairment important determinants of the female:male ratio for major depression? , 1994, Journal of affective disorders.

[30]  E. Young.  Glucocorticoid cascade hypothesis revisited: Role of gonadal steroids , 1995 .

[31]  B. Parry.  Sex hormones, orcadian rhythms, and depressive vulnerability , 1995 .

[32]  P. Whybrow.  Sex differences in thyroid axis function: Relevance to affective disorder and its treatment , 1995 .

[33]  E. Caine,et al.  Older Age and the Underreporting of Depressive Symptoms , 1995, Journal of the American Geriatrics Society.

[34]  N. Breslau,et al.  Sex differences in depression: a role for preexisting anxiety , 1995, Psychiatry Research.

[35]  R. Kessler,et al.  The structure of the genetic and environmental risk factors for six major psychiatric disorders in women. Phobia, generalized anxiety disorder, panic disorder, bulimia, major depression, and alcoholism. , 1995, Archives of general psychiatry.

[36]  A. Sowden,et al.  Gender and depression in Anglo-Jewry , 1995, Psychological Medicine.

[37]  S. Checkley.  The neuroendocrinology of depression , 1996 .

[38]  P. McGuffin,et al.  A hospital-based twin register of the heritability of DSM-IV unipolar depression. , 1996, Archives of general psychiatry.

[39]  George W. Brown.  Genetics of depression: a social science perspective , 1996 .

[40]  C. Brewin.  Cognitive processing of adverse experiences , 1996 .

[41]  R. Cadoret,et al.  Depression spectrum disease, I: The role of gene-environment interaction. , 1996, The American journal of psychiatry.

[42]  A. Farmer.  The genetics of depressive disorders , 1996 .

[43]  R. Kessler,et al.  Comorbidity of DSM–III–R Major Depressive Disorder in the General Population: Results from the US National Comorbidity Survey , 1996, British Journal of Psychiatry.

[44]  H. Aro,et al.  Sex differences in coping and depression among young adults. , 1996, Social science & medicine.

[45]  T. Craig.  Adversity and depression , 1996 .

[46]  R. Harrington.  Family-genetic findings in child and adolescent depressive disorders , 1996 .

[47]  P. Bebbington.  The origins of sex differences in depressive disorder: Bridging the gap , 1996 .

[48]  P. Spinhoven,et al.  Defense style in depressed and anxious psychiatric outpatients: an explorative study. , 1997, The Journal of nervous and mental disease.

[49]  D. Hadzi-Pavlovic,et al.  Fifteen years on: evolving ideas in researching sex differences in depression , 1997, Psychological Medicine.

[50]  D W Fulker,et al.  The familial aggregation of depressive symptoms, antisocial behavior, and alcohol abuse. , 1997, American journal of medical genetics.

[51]  P. Lewinsohn,et al.  Correspondence between adolescent report and parent report of psychiatric diagnostic data. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[52]  M. Seeman.  Psychopathology in women and men: focus on female hormones. , 1997, The American journal of psychiatry.

[53]  Christopher G. Davis,et al.  The familial aggregation of common psychiatric and substance use disorders in the National Comorbidity Survey: A family history study , 1997, British Journal of Psychiatry.

[54]  J. Nazroo,et al.  Gender differences in the onset of depression following a shared life event: a study of couples , 1997, Psychological Medicine.

[55]  V. Lehtinen,et al.  Sex differences in the association between childhood experiences and adult depression , 1998, Psychological Medicine.

[56]  A. Bifulco,et al.  Predicting depression in women: the role of past and present vulnerability , 1998, Psychological Medicine.

[57]  S. Weich,et al.  Social roles and gender difference in the prevalence of common mental disorders , 1998, British Journal of Psychiatry.

[58]  K. Kendler,et al.  A population-based twin study of self-esteem and gender , 1998, Psychological Medicine.

[59]  E J Costello,et al.  Puberty and depression: the roles of age, pubertal status and pubertal timing , 1998, Psychological Medicine.

[60]  P. Bracke.  Sex differences in the course of depression: evidence from a longitudinal study of a representative sample of the Belgian population , 1998, Social Psychiatry and Psychiatric Epidemiology.

[61]  B. Grant,et al.  Family history of alcoholism and gender: their combined effects on DSM-IV alcohol dependence and major depression. , 1998, Journal of studies on alcohol.

[62]  P. Bebbington.  Sex and depression , 1998, Psychological Medicine.

[63]  Examining sex differences in the impact of anticipated and actual life events. , 1998, Journal of affective disorders.

[64]  K. Kendler,et al.  Causal relationship between stressful life events and the onset of major depression. , 1999, The American journal of psychiatry.

[65]  C. Mazure,et al.  Childhood sexual abuse as a risk factor for depression in women: psychosocial and neurobiological correlates. , 1999, The American journal of psychiatry.

[66]  K. Kendler,et al.  A population-based twin study of lifetime major depression in men and women. , 1999, Archives of general psychiatry.

[67]  L. Bierut,et al.  Major depressive disorder in a community-based twin sample: are there different genetic and environmental contributions for men and women? , 1999, Archives of general psychiatry.

[68]  A. Kolk,et al.  Gender differences in physical symptoms and illness behavior. A health diary study. , 1999, Social science & medicine.

[69]  B. Silverstein.  Gender difference in the prevalence of clinical depression: the role played by depression associated with somatic symptoms. , 1999, The American journal of psychiatry.

[70]  A Pickles,et al.  The influence of genetic factors and life stress on depression among adolescent girls. , 1999, Archives of general psychiatry.