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Multicenter Study
. 2021 Sep;38(9):896-906.
doi: 10.1002/da.23165. Epub 2021 Jun 10.

Sex-related effects in major depressive disorder: Results of the European Group for the Study of Resistant Depression

Lucie Bartova  1 , Markus Dold  1 , Gernot Fugger  1 , Alexander Kautzky  1 , Marleen M M Mitschek  1 , Ana Weidenauer  1 , Marius G Hienert  1 , Richard Frey  1 , Laura Mandelli  2 , Joseph Zohar  3 , Julien Mendlewicz  4 , Daniel Souery  4   5 , Stuart Montgomery  6 , Chiara Fabbri  2   7 , Alessandro Serretti  2 , Siegfried Kasper  1   8
Affiliations
Multicenter Study

Sex-related effects in major depressive disorder: Results of the European Group for the Study of Resistant Depression

Lucie Bartova et al. Depress Anxiety. 2021 Sep.

Abstract

Background: Sex-related effects on the evolution and phenotype of major depressive disorder (MDD) were reported previously.

Methods: This European multicenter cross-sectional study compared sociodemographic, clinical, and treatment patterns between males and females in a real-world sample of 1410 in- and outpatients with current MDD.

Results: Male MDD patients (33.1%) were rather inpatients, suffered from moderate to high suicidality levels, received noradrenergic and specific serotonergic antidepressants (ADs) as first-line AD treatment, generally higher mean AD daily doses, and showed a trend towards a more frequent administration of add-on treatments. Female MDD patients (66.9%) were rather outpatients, experienced lower suicidality levels, comorbid thyroid dysfunction, migraine, asthma, and a trend towards earlier disease onset.

Conclusions: The identified divergencies may contribute to the concept of male and female depressive syndromes and serve as predictors of disease severity and course, as they reflect phenomena that were repeatedly related to treatment-resistant depression (TRD). Especially the greater necessity of inpatient treatment and more complex psychopharmacotherapy in men may reflect increased therapeutic efforts undertaken to treat suicidality and to avoid TRD. Hence, considering sex may guide the diagnostic and treatment processes towards targeting challenging clinical manifestations including comorbidities and suicidality, and prevention of TRD and chronicity.

Keywords: gender; major depressive disorder; male depression; sex; treatment response.

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Conflict of interest statement

Dr. Bartova has received travel grants and consultant/speaker honoraria from AOP Orphan, Medizin Medien Austria, Vertretungsnetz, Schwabe Austria, Janssen and Angelini. Dr. Dold has received travel grants and consultant/speaker honoraria from Janssen‐Cilag. Dr. Frey has received consulting fees from Janssen‐Cilag. Dr. Zohar has received grant/research support from Lundbeck, Servier, and Pfizer; he has served as a consultant or on the advisory boards for Servier, Pfizer, Solvay, and Actelion; and he has served on speakers' bureaus for Lundbeck, GlaxoSmithKline, Jazz, and Solvay. Dr. Mendlewicz is a member of the board of the Lundbeck International Neuroscience Foundation and of the advisory board of Servier. Dr. Souery has received grant/research support from GlaxoSmithKline and Lundbeck; and he has served as a consultant or on advisory boards for AstraZeneca, Bristol‐Myers Squibb, Eli Lilly, Janssen, and Lundbeck. Dr. Montgomery has served as a consultant or on advisory boards for AstraZeneca, Bionevia, Bristol‐Myers Squibb, Forest, GlaxoSmithKline, Grunenthal, Intellect Pharma, Johnson and Johnson, Lilly, Lundbeck, Merck, Merz, M's Science, Neurim, Otsuka, Pierre Fabre, Pfizer, Pharmaneuroboost, Richter, Roche, Sanofi, Sepracor, Servier, Shire, Synosis, Takeda, Theracos, Targacept, Transcept, UBC, Xytis, and Wyeth. Dr. Fabbri has been supported by Fondazione Umberto Veronesi (https://www.fondazioneveronesi.it). Dr. Serretti has served as a consultant or speaker for Abbott, Abbvie, Angelini, AstraZeneca, Clinical Data, Boehringer, Bristol‐Myers Squibb, Eli Lilly, GlaxoSmithKline, Innovapharma, Italfarmaco, Janssen, Lundbeck, Naurex, Pfizer, Polifarma, Sanofi, and Servier. Within the last 3 years, Dr. Kasper received grants/research support, consulting fees, and/or honoraria from Angelini, Celegne GmbH, Eli Lilly, Janssen‐Cilag Pharma GmbH, KRKA‐Pharma, Lundbeck A/S, Mundipharma, Neuraxpharm, Pfizer, Sanofi, Schwabe, Servier, Shire, Sumitomo Dainippon Pharma Co. Ltd., Sun Pharma, and Takeda. All other authors declare that there are no conflicts of interest.

References

    1. Abbott, A. V., Snyder, C. L., & Vogel, M. E. (1984). Type A behavior and coronary heart disease. American Family Physician, 30(4), 209–217. - PubMed
    1. Angst, J., Gamma, A., Gastpar, M., Lepine, J. P., Mendlewicz, J., & Tylee, A., Depression Research in European Society Study . (2002). Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies. European Archives of Psychiatry and Clinical Neuroscience, 252(5), 201–209. 10.1007/s00406-002-0381-6 - DOI - PubMed
    1. Azorin, J. M., Belzeaux, R., Fakra, E., Kaladjian, A., Hantouche, E., Lancrenon, S., & Adida, M. (2014). Gender differences in a cohort of major depressive patients: Further evidence for the male depression syndrome hypothesis. Journal of Affective Disorders, 167, 85–92. 10.1016/j.jad.2014.05.058 - DOI - PubMed
    1. Bartova, L., Dold, M., Kautzky, A., Fabbri, C., Spies, M., Serretti, A., Souery, D., Mendlewicz, J., Zohar, J., Montgomery, S., Schosser, A., & Kasper, S. (2019). Results of the European Group for the Study of Resistant Depression (GSRD)—Basis for further research and clinical practice. World Journal of Biological Psychiatry, 20(6), 427–448. 10.1080/15622975.2019.1635270 - DOI - PubMed
    1. Bauer, M., Severus, E., Moller, H. J., & Young, A. H., WFSBP Task Force on Unipolar Depressive Disorders . (2017). Pharmacological treatment of unipolar depressive disorders: Summary of WFSBP guidelines. International Journal of Psychiatry in Clinical Practice, 21, 166–176. 10.1080/13651501.2017.1306082 - DOI - PubMed

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