Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health

Lara Marise Wierenga^{1

2}, Amber Ruigrok^{3

4}, Eira Ranheim Aksnes^{5

6

7}, Claudia Barth^{5

6}, Dani Beck^{5

6

7}, Sarah Burke⁸, Arielle Crestol^{5

6}, Lina van Drunen^{1

2}, Maria Ferrara^{9

10}, Liisa Ann Margaret Galea¹¹, Anne-Lise Goddings¹², Markus Hausmann¹³, Inka Homanen^{1

2}, Ineke Klinge^{14

15}, Ann-Marie de Lange^{16

17

18}, Lineke Geelhoed-Ouwerkerk^{1

2}, Anna van der Miesen¹⁹, Ricarda Proppert²⁰, Carlotta Rieble²⁰, Christian Krog Tamnes^{5

6

7}, Marieke Geerte Nynke Bos^{1

2}

Affiliations

¹ Institute of Psychology, Leiden University, Leiden, the Netherlands.
² Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands.
³ Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
⁴ Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
⁵ Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
⁶ NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
⁸ Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
⁹ Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
¹⁰ University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
¹¹ Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹² University College London Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.
¹³ Department of Psychology, Durham University, Durham, United Kingdom.
¹⁴ Dutch Society for Gender & Health, the Netherlands.
¹⁵ Gendered Innovations at European Commission, Brussels, Belgium.
¹⁶ Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
¹⁷ Department of Psychology, University of Oslo, Oslo, Norway.
¹⁸ Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
¹⁹ Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
²⁰ Department of Clinical Psychology, Leiden University, Leiden, the Netherlands.

PMID: 38312851
PMCID: PMC10837069
DOI: 10.1016/j.bpsgos.2023.100283

Review

Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health

Lara Marise Wierenga et al. Biol Psychiatry Glob Open Sci. 2023.

. 2023 Dec 30;4(2):100283.

doi: 10.1016/j.bpsgos.2023.100283. eCollection 2024 Mar.

Authors

Affiliations

¹ Institute of Psychology, Leiden University, Leiden, the Netherlands.
² Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands.
³ Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
⁴ Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
⁵ Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.
⁶ NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁷ PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
⁸ Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
⁹ Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.
¹⁰ University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Behavior, University S. Anna Hospital and Health Trust, Ferrara, Italy.
¹¹ Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹² University College London Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.
¹³ Department of Psychology, Durham University, Durham, United Kingdom.
¹⁴ Dutch Society for Gender & Health, the Netherlands.
¹⁵ Gendered Innovations at European Commission, Brussels, Belgium.
¹⁶ Laboratory for Research in Neuroimaging, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
¹⁷ Department of Psychology, University of Oslo, Oslo, Norway.
¹⁸ Department of Psychiatry, University of Oxford, Oxford, United Kingdom.
¹⁹ Department of Child and Adolescent Psychiatry, Center of Expertise on Gender Dysphoria, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
²⁰ Department of Clinical Psychology, Leiden University, Leiden, the Netherlands.

PMID: 38312851
PMCID: PMC10837069
DOI: 10.1016/j.bpsgos.2023.100283

Erratum in

Erratum.
[No authors listed] [No authors listed] Biol Psychiatry Glob Open Sci. 2024 Apr 16;4(4):100319. doi: 10.1016/j.bpsgos.2024.100319. eCollection 2024 Jul. Biol Psychiatry Glob Open Sci. 2024. PMID: 38765183 Free PMC article.

Abstract

There are prominent sex/gender differences in the prevalence, expression, and life span course of mental health and neurodiverse conditions. However, the underlying sex- and gender-related mechanisms and their interactions are still not fully understood. This lack of knowledge has harmful consequences for those with mental health problems. Therefore, we set up a cocreation session in a 1-week workshop with a multidisciplinary team of 25 researchers, clinicians, and policy makers to identify the main barriers in sex and gender research in the neuroscience of mental health. Based on this work, here we provide recommendations for methodologies, translational research, and stakeholder involvement. These include guidelines for recording, reporting, analysis beyond binary groups, and open science. Improved understanding of sex- and gender-related mechanisms in neuroscience may benefit public health because this is an important step toward precision medicine and may function as an archetype for studying diversity.

Keywords: Brain; Gender; Mental health; Neurodiverse conditions; Sex.

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Figures

**Figure 1**
Both sex-related attributes (orange) and gender-related social-cultural factors (blue) moderate and mediate differences in the emergence, expression and diagnosis of mental health conditions. Moreover, sex- and gender-related effects interact and converge mechanisms shaping neurodiverse conditions. They moderate and mediate the behavioral and cognitive manifestations of neurodevelopmental health conditions and shape brain development. In addition, sex differences in the brain may act as compensating mechanisms that will limit sex differences in behavioral and cognitive outcome patterns (e.g., X-inactivation). It is important to better understand these differential pathways and how they interact to reduce recognition and diagnostic biases.

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References

1. Pallier P.N., Ferrara M., Romagnolo F., Ferretti M.T., Soreq H., Cerase A. Chromosomal and environmental contributions to sex differences in the vulnerability to neurological and neuropsychiatric disorders: Implications for therapeutic interventions. Prog Neurobiol. 2022;219 - PubMed
1. Dalsgaard S., Thorsteinsson E., Trabjerg B.B., Schullehner J., Plana-Ripoll O., Brikell I., et al. Incidence rates and cumulative incidences of the full spectrum of diagnosed mental disorders in childhood and adolescence. JAMA Psychiatry. 2020;77:155–164. - PMC - PubMed
1. Kessler R.C., McGonagle K.A., Zhao S., Nelson C.B., Hughes M., Eshleman S., et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8–19. - PubMed
1. Kessler R.C., Berglund P., Demler O., Jin R., Merikangas K.R., Walters E.E. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62:593–602. - PubMed
1. Bao A.M., Swaab D.F. Sex differences in the brain, behavior, and neuropsychiatric disorders. Neuroscientist. 2010;16:550–565. - PubMed

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Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health

Affiliations

Recommendations for a Better Understanding of Sex and Gender in the Neuroscience of Mental Health

Authors

Affiliations

Erratum in

Abstract

Figures

References

Publication types

LinkOut - more resources

Full Text Sources