title: Gender differences in prevalence of depression among patients receiving palliative care: the role of dependency.
abstract: BACKGROUND
  in community studies the prevalence of depression is higher in women than men; however, in palliative care settings this relationship is usually less strong, absent or reversed.
  
  
  OBJECTIVE
  to identify reasons for excess depression among men receiving palliative care.
  
  
  METHODS
  cross-sectional study.
  
  
  METHODS
  we interviewed 300 patients recruited from a large hospice in South East London. Depression was measured using the Primary Care Evaluation of Mental Disorder.
  
  
  RESULTS
  the higher prevalence of depression among men was not explained by a higher prevalence of particular types of cancer nor confounding by other covariates. Possible effect modifiers were examined. Depending on others for help with basic tasks (eating, dressing, washing or using the toilet) was a risk factor for depression in men only, with 37.8% of dependent men being depressed compared to 2.4% of similarly affected women (OR = 24.3, 3.1-193.2, p = 0.003). We observed a dose-response effect between the level of dependency and depression in men (p for trend = 0.01).
  
  
  CONCLUSIONS
  depending on others for help with basic tasks appears to contribute to the burden of depression among men with terminal illness. This gender-specific association may explain why the usual gender differences in depression prevalence are not observed in palliative care.
authors.affiliation: Section of Epidemiology, Department of Health Service and Population Research, Institute of Psychiatry, King's College London, UK. richd.hayes@gmail.com
authors.forename: Richard D
authors.initials: RD
authors.lastname: Hayes
authors.forename: William
authors.initials: W
authors.lastname: Lee
authors.forename: Lauren
authors.initials: L
authors.lastname: Rayner
authors.forename: Annabel
authors.initials: A
authors.lastname: Price
authors.forename: Barbara
authors.initials: B
authors.lastname: Monroe
authors.forename: Penny
authors.initials: P
authors.lastname: Hansford
authors.forename: Nigel
authors.initials: N
authors.lastname: Sykes
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017004:Codependency, Psychological; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult