Women and anxiety

Abstract

Some, but not all, of the DSM-III-R defined anxiety disorders are more frequent in women than in men; social phobia and obsessive-compulsive disorder are most equal in sex ratio. Clinical and community-epidemiologic samples tend to agree, and family studies indicate that the higher frequency of anxiety in women may represent one clinical presentation of a familial affective disorder/substance abuse-sociopathy "spectrum" disorder. Developmental studies suggest that gender differences relevant to the expression of anxiety symptoms may start quite early in life; psychodynamic theories would also tend to implicate early learning and experience. Women may be more responsive to life stresses, which might influence the occurrence of anxiety symptoms; however, the actual role and source of these stresses is not yet fully understood. Physiologic differences in brain structure between men and women are undoubtedly important in the gender differences in symptoms observed. Clinical management can be affected by these differences.