The influence of age and sex on the prevalence of depressive conditions: report from the National Survey of Psychiatric Morbidity

Women are consistently reported to have a greater prevalence of depressive disorders than men. The reason for this is unclear, and is as likely to be social as biological. There is some evidence that the excess of depression is greater during women's reproductive lives. Data from the National Survey of Psychiatric Morbidity were used to test the hypothesis that the excess disappeared in the post-menopausal years and that obvious social explanations for this were inadequate. Subjects (n = 9792) from a random sample of the British population provided data for the analysis. Lay interviewers using the CIS-R carried out psychiatric assessment. Subjects with ICD-10 depressive episode or mixed anxiety/depression were compared with the remainder. Social variables that were likely to contribute to a post-menopausal decline in depressive disorders were controlled in logistic regression analyses. There was a clear reversal of the sex difference in prevalence of depression in those over age 55. This could not be explained in terms of differential effects of marital status, childcare, or employment status. This large and representative survey adds considerably to the increasingly held view that the sex difference in prevalence of depression is less apparent in later middle age. This may be linked to the menopause, and our attempts to explain it in terms of obvious conditions among social variables were not successful. More specific studies are required to clarify the finding.

[1]  M. Petticrew,et al.  The National Psychiatric Morbidity Surveys of Great Britain – strategy and methods , 1997, Psychological Medicine.

[2]  P Bebbington,et al.  The National Psychiatric Morbidity Surveys of Great Britain – initial findings from the Household Survey , 1997, Psychological Medicine.

[3]  G C Patton,et al.  Menarche and the onset of depression and anxiety in Victoria, Australia. , 1996, Journal of epidemiology and community health.

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

[5]  Risto Lehtonen,et al.  Practical Methods for Design and Analysis of Complex Surveys , 1995 .

[6]  B. Pfohl,et al.  Age‐Related Differences in the Symptomatic Expression of Major Depression , 1995, The Journal of nervous and mental disease.

[7]  P. Lewinsohn,et al.  Major depression in community adolescents: age at onset, episode duration, and time to recurrence. , 1994, Journal of the American Academy of Child and Adolescent Psychiatry.

[8]  M. Ansseau,et al.  Effects of gender and diagnosis on growth hormone response to clonidine for major depression: a large-scale multicenter study. , 1994, The American journal of psychiatry.

[9]  G. Herbison,et al.  Otago Women's Health Survey 30-Month Follow-Up , 1993, British Journal of Psychiatry.

[10]  Faith K. Greulich,et al.  The role of gender-related processes in the development of sex differences in self-evaluation and depression. , 1993, Journal of affective disorders.

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

[12]  Jacob Cohen,et al.  An epidemiological study of disorders in late childhood and adolescence--II. Persistence of disorders. , 1993, Journal of child psychology and psychiatry, and allied disciplines.

[13]  N. Milburn,et al.  Symptoms of depression among older African-Americans: an analysis of gender differences. , 1992, The Gerontologist.

[14]  J. Copeland,et al.  Risk factors for depression in elderly people: a prospective study , 1992, Acta psychiatrica Scandinavica.

[15]  G Lewis,et al.  Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers , 1992, Psychological Medicine.

[16]  R. Bland.  Psychiatric Disorders in America: The Epidemiologic Catchment Area Study , 1992 .

[17]  M. Rutter,et al.  Effects of age and pubertal status on depression in a large clinical sample , 1992, Development and Psychopathology.

[18]  J. Bancroft,et al.  Is Sex Necessarily a Risk Factor to Depression? , 1991, British Journal of Psychiatry.

[19]  A. Petersen,et al.  Adolescent depression: Why more girls? , 1991, Journal of youth and adolescence.

[20]  M. Hunter.  Somatic experience of the menopause: A prospective study , 1991 .

[21]  T. Garrity,et al.  Prevalence and correlates of depressive symptoms among older U.S. adults. , 1990, American journal of preventive medicine.

[22]  M. Hunter.  Emotional well-being, sexual behaviour and hormone replacement therapy. , 1990, Maturitas.

[23]  K. Matthews,et al.  Influences of natural menopause on psychological characteristics and symptoms of middle-aged healthy women. , 1990, Journal of consulting and clinical psychology.

[24]  T. Brugha,et al.  SCAN. Schedules for Clinical Assessment in Neuropsychiatry. , 1990, Archives of general psychiatry.

[25]  M. Hunter,et al.  Psychological and somatic experience of the menopause: a prospective study [corrected]. , 1990, Psychosomatic medicine.

[26]  G. Herbison,et al.  Marriage, motherhood and psychiatric morbidity in New Zealand , 1988, Psychological Medicine.

[27]  T. Hassard,et al.  Researching the symptoms of menopause: an exercise in methodology. , 1988, Maturitas.

[28]  R. Bland,et al.  LIFETIME PREVALENCE OF PSYCHIATRIC DISORDERS IN EDMONTON , 1988, Acta psychiatrica Scandinavica. Supplementum.

[29]  J. Mckinlay,et al.  The relative contributions of endocrine changes and social circumstances to depression in mid-aged women. , 1987, Journal of health and social behavior.

[30]  M. Choquet,et al.  Development of self-perceived risk behaviour and psychosomatic symptoms in adolescents: a longitudinal approach. , 1987, Journal of adolescence.

[31]  Anthony F Jorm.  Sex and Age Differences in Depression: A Quantitative Synthesis of Published Research , 1987, The Australian and New Zealand journal of psychiatry.

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

[33]  D. Gath,et al.  Psychiatric disorder and gynaecological symptoms in middle aged women: a community survey. , 1987, British medical journal.

[34]  J. Eagles,et al.  Ageing and Affective Disorders: The Age at First Onset of Affective Disorders in Scotland, 1969–1978 , 1985, British Journal of Psychiatry.

[35]  A. Pieter.  The social and psychological origins of the climacteric syndrome , 1985 .

[36]  D. Cooke.  Psychosocial Vulnerability to Life Events during the Climacteric , 1985, British Journal of Psychiatry.

[37]  J. Greene,et al.  The Social and Psychological Origins of the Climacteric Syndrome , 1984 .

[38]  G. Brown,et al.  Psychiatric disorder in London and North Uist. , 1977, Social science & medicine.

[39]  M. Blanchard.  Old age depression-a biological inevitability? , 1996 .

[40]  Howard Meltzer,et al.  The prevalence of psychiatric morbidity among adults living in private households , 1995 .

[41]  Hj Norussis,et al.  SPSS for Windows , 1993 .

[42]  P. Kaufert,et al.  The Manitoba Project: a re-examination of the link between menopause and depression. , 1992, Maturitas.

[43]  P. Bebbington.  The social epidemiology of clinical depression. , 1988 .

[44]  P. Cleary,et al.  Differences in the appraisal of health between aged and middle-aged adults. , 1987, Journal of gerontology.

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

[46]  P. Warr,et al.  Paid employment and women's psychological well-being , 1982 .

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