title: Differences in the Expression of Symptoms in Men Versus Women with Depression: A Systematic Review and Meta-analysis.
abstract: While some studies suggest that men and women report different symptoms associated with depression, no published systematic review or meta-analysis has analyzed the relevant research literature. This article aims to review the evidence of gender differences in symptoms associated with depression.
  
  
  
  PubMed, Cochrane, and PsycINFO databases, along with further identified references lists, were searched. Thirty-two studies met the inclusion criteria. They included 108,260 participants from clinical and community samples with a primary presentation of unipolar depression. All 32 studies were rated for quality and were tested for publication bias. Meta-analyses were conducted on the 26 symptoms identified across the 32 studies to assess for the effect of gender.
  
  
  
  The studies indicate a small, significant association of gender with some symptoms. Depressed men reported alcohol/drug misuse (Hedges's g = 0.26 [95% confidence interval (CI), 0.11-0.42]) and risk taking/poor impulse control (g = 0.58 [95% CI, 0.47-0.69]) at a greater frequency and intensity than depressed women. Depressed women reported symptoms at a higher frequency and intensity that are included as diagnostic criteria for depression such as depressed mood (g = -0.20 [95% CI, -0.33 to -0.08]), appetite disturbance/weight change (g = -0.20 [95% CI, -0.28 to -0.11]), and sleep disturbance (g = -0.11 [95% CI, -0.19 to -0.03]).
  
  
  
  Results are consistent with existing research on gender differences in the prevalence of substance use and mood disorders, and of their co-occurrence. They highlight the potential utility of screening for substance misuse, risk taking, and poor impulse control when assessing depression in men. Future research is warranted to clarify gender-specific presentations of depression and co-occurring symptoms.
authors.affiliation: From the School of Psychology (Ms. Cavanagh and Dr. Caputi), Illawarra Health & Medical Research Institute, Graduate School of Medicine (Dr. Wilson), and Centre for Health Initiatives (Dr. Caputi), University of Wollongong; Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology (Dr. Kavanagh) (all Australia).
authors.forename: Anna
authors.initials: A
authors.lastname: Cavanagh
authors.forename: Coralie J
authors.initials: CJ
authors.lastname: Wilson
authors.forename: David J
authors.initials: DJ
authors.lastname: Kavanagh
authors.forename: Peter
authors.initials: P
authors.lastname: Caputi
mesh_terms: D003863:Depression / Q000503:physiopathology*; D003866:Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D012737:Sex Factors