Gender differences in depression. Critical review

Abstract

Background: With few exceptions, the prevalence, incidence and morbidity risk of depressive disorders are higher in females than in males, beginning at mid-puberty and persisting through adult life.

Aims: To review putative risk factors leading to gender differences in depressive disorders.

Method: A critical review of the literature, dealing separately with artefactual and genuine determinants of gender differences in depressive disorders.

Results: Although artefactual determinants may enhance a female preponderance to some extent, gender differences in depressive disorders are genuine. At present, adverse experiences in childhood, depression and anxiety disorders in childhood and adolescence, sociocultural roles with related adverse experiences, and psychological attributes related to vulnerability to life events and coping skills are likely to be involved. Genetic and biological factors and poor social support, however, have few or no effects in the emergence of gender differences.

Conclusions: Determinants of gender differences in depressive disorders are far from being established and their combination into integrated aetiological models continues to be lacking.