title: Reflections on masculinity, culture and the diagnosis of depression.
abstract: OBJECTIVE
  To inform the debate on the relationship between gender and depression by examining clinicians' ratings on selected HoNos items in two cultural groups.
  
  
  METHODS
  Scores on items 1 (overactivity/aggression) and 2 (depression) as recorded by clinicians in the CAOS study of more than 12,000 unselected New Zealand psychiatric service users were analysed by gender and self identified ethnicity.
  
  
  RESULTS
  The lowest ratings for depression and highest for overactivity/agression were assigned to Māori males. Female Māori, were rated next, followed by male non-Māori. Female non-Māori were rated highest on depression and lowest on overactivity/agression.
  
  
  CONCLUSIONS
  Amongst the hypotheses to explain these findings are those relating to service utilization, rater bias, criteria bias, and cultural pathoplastic effects. These questions need answers.
authors.affiliation: Waikato Clinical School, Waikato Hospital, Hamilton, New Zealand. mellsopg@waikatodhb.govt.nz
authors.forename: Graham
authors.initials: G
authors.lastname: Mellsop
authors.forename: Barry
authors.initials: B
authors.lastname: Smith
mesh_terms: D000374:Aggression; D003469:Culture; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005006:Ethnicity; D005260:Female; D005783:Gender Identity; D006304:Health Status; D006801:Humans; D007600:Judgment; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D012727:Sex Characteristics