Gender differences in unipolar depression: an update of epidemiological findings and possible explanations.
OBJECTIVE
To give an update on epidemiological findings on sex differences in the prevalence of unipolar depression and putative risk factors.


METHODS
Systematic review of the literature.


RESULTS
Recent epidemiological research yields additional evidence for a female preponderance in unipolar depression, holding true across different cultural settings. Current explanations include artefacts, genetic, hormonal, psychological and psychosocial risk factors. Rather consistently, intrapsychic and psychosocial gender role related risk factors have been identified which may contribute to the higher depression risk in women. Gender role aspects are also reflected in endocrine stress reactions and possibly influence associated neuropsychological processes.


CONCLUSIONS
There is a need for more integrative models taking into account psychological, psychosocial, and macrosocial risk factors as well as their interactions, which also connect these factors with physiological and endocrine responses. Furthermore, it is conceivable that across the life span, as well as across cultural settings, individual risk factors will add with varying emphasis to the higher prevalence of depression in women.
Kuehner
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Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany. kuehner@zi-mannheim.de
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors