Is gender a factor in psychiatrists' evaluation and treatment of patients with major depression?
BACKGROUND
Gender differences in clinical assessment and treatment have been reported in several areas of medicine. We examine whether differences exist in the routine outpatient psychiatric management of men and women with major depression.


METHODS
Psychiatrists practicing in the community completed case forms on a systematic sample of their adult outpatients with major depression. Comparisons are presented between male (n=261) and female (n=472) patients focusing on their background characteristics, clinical presentation, assessment, and treatment. Significant gender disparities in assessment and treatment are also examined with respect to the gender of the treating psychiatrist.


RESULTS
Although male and female patients had generally similar clinical profiles, a significantly greater proportion of males than females had psychomotor retardation and substance use disorders. No significant gender differences were observed in the assessment of depressive symptoms, psychiatric comorbidities, and treatment with antidepressant medications or psychotherapy. However, a significantly smaller percentage of depressed women than men received assessments of sexual function and medication-related sexual side effects. Female patients were also less likely to have discussed their treatment preferences with their psychiatrists.


CONCLUSIONS
Only a minority (33.2%) of psychiatrists invited to participate contributed patients to this study. The results are based on structured assessments completed by practicing psychiatrists rather than patient self-assessments or independent research assessments.


CONCLUSIONS
Although we find overall little evidence of gender bias in the clinical management of major depression, both male and female psychiatrists need to further explore sexual function and treatment preferences in female patients.
New York State Psychiatric Institute/Department of Psychiatry, College of Physicians & Surgeons of Columbia University, 1051 Riverside Drive, Unit 24, New York, NY 10032, USA. olfsonm@child.cpmc.columbia.edu
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M
Olfson
D A
DA
Zarin
B S
BS
Mittman
J S
JS
McIntyre
D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D011287:Prejudice; D011369:Professional-Patient Relations; D011570:Psychiatry; D012737:Sex Factors; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced