Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies.
BACKGROUND
While there is ample evidence that the prevalence rates for major depressive disorder (MDD) in the general population are higher in women than in men, there is little data on gender differences as regard to symptoms, causal attribution, help-seeking, coping, or the consequences of depression.


METHODS
The large DEPRES Study dataset covering representative population samples of six European countries (wave I: 38,434 men and 40,024 women; wave II: 563 men and 1321 women treated for depression) was analyzed for gender differences.


RESULTS
In wave I marked gender differences were found in the six-month prevalence rate for major depression but less so for minor depression; the gender differences for major depression persisted across all age groups. Even after stratification by clinically significant impairment and paid employment status, men reported fewer symptoms than women; as a consequence, men reached the diagnostic threshold less often. In wave II there were clear gender differences in causal attribution and in coping. Men coped by increasing their sports activity and consumption of alcohol and women through emotional release and religion. Women felt the effects of depression in their quality of sleep and general health, whereas men felt it more in their ability to work.


CONCLUSIONS
The second wave of the study comprises treated depressives only and may be less representative than the first wave.
Angst
J
J
Zurich University Psychiatric Hospital, Lenggstrasse 31, P O Box 68, 8029 Zurich, Switzerland. jangst@bli.unizh.ch
Gamma
A
A
Gastpar
M
M
Lépine
J-P
JP
Mendlewicz
J
J
Tylee
A
A
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010865:Pilot Projects; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D017678:Sex Distribution; D012803:Sick Role; D013030:Spain / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology