"Female Preponderance" of Depression in Non-clinical Populations: A Meta-Analytic Study

Abstract

Clinical observations and research suggest a female preponderance in major depressive disorder. However, it is unclear whether a similar gender difference is found for the reporting of depressive symptoms in non-clinical populations. The present meta-analysis was conducted to address this issue. We searched for published papers targeting non-clinical populations in which the 21-item Beck Depression Inventory (BDI) was used. Eighty-four papers (91 studies) published between 1977 and 2014 were included in the final meta-analysis, which comprised 23,579 males and 29,470 females. Females in the general population reported higher level of depressive symptoms than males (d = -0.187, corresponding to 1.159 points in the 21-item BDI). This pattern was not found to influence by years of publication, socioeconomic status, or version of the BDI used. Using age group as a moderator, studies with adolescents and young adults were found to show a smaller effect size than studies with older participants. Our results appear to confirm the "female preponderance" in the level of self-report depressive symptoms in the general population, and support the social gender role theory in explaining gender difference over biological susceptibility theory and evolutionary theory.

Keywords: BDI; age; depression; economic status; gender difference; social gender role.

FIGURE 1

Flowchart for the inclusion of published data for the current meta-analysis.

FIGURE 2

Funnel plot of standard errors as a function of standard difference in the means.

FIGURE 3

Scatter plots between GDP (gross domestic product) per capita and male BDI (Beck Depression Inventory) score (red), between GDP per capita and female BDI score (blue), and between GDP per capita and Cohen’s d (black). All data were normalized for illustration purpose.