Gender Differences in Depression

Epidemiologic studies have revealed a twofold greater prevalence of depression in females than males. Frequently, the symptoms and comorbidities of depression also differ by gender. Many psychosocial factors and biological factors have been studied that may explain the different manifestations and prevalence of depression according to gender. Atypical symptoms, somatic symptoms, and parasuicidal behavior are more frequent in females. A male-specific depressive syndrome including acting out and increased impulsivity has been suggested. Anxiety disorder is more frequent in depressed females, whereas substance abuse is more frequent in males. Sociocultural factors, such as role restriction and discrimination in the workplace, certain traumas that occur more frequently in females (e.g., sexual assault), and coping style (e.g., rumination) appear to interact and contribute to the female predominance for depression. Still, most study findings and evidence regarding biological factors lack consistency and are insufficient for drawing conclusions. But gonadal hormones, the hypothalamic-pituitary-adrenal axis, and neurotransmitters seem to be closely related to each other and produce gender differences in depression. Especially, changes in gonadal hormones during the menstrual cycle, pregnancy, childbirth, and menopause appear to play key roles for some female-specific depressive syndromes.