Clinical depression more common in females
Major depressive disorder (MDD) appears to be more prevalent in females than in males, particularly in those who are divorced or widowed, a recent study from Singapore has found.
“[T]he finding that MDD is more prevalent among women, particularly in the younger age group, suggests the need to involve and educate parents and teachers about the signs of depression,” researchers said, adding that females also tend to suffer from a higher risk of generalised anxiety disorder (GAD).
The research team interviewed 6,616 Singaporean adults (51.5 percent female) and found a total of 417 MDD cases, resulting in a prevalence rate of 5.8 percent. There were significantly more female than male MDD cases (247 vs 170; p=0.003). [Singapore Med J 2017;58:649-655]
The study’s main finding is consistent with values in the literature, which report MDD prevalence that is 1.5 to 3 times higher in females. [J Affect Disord 2003;74:5-13]
“While the exact reason for such gender differences in relation to MDD prevalence is not known, it is likely to be a myriad of social, behavioural, psychological and biological factors that possibly interact with one another,” researchers explained.
In a subsequent multivariable analysis adjusted for age group, education, income, marital status, ethnicity and employment, females with MDD were statistically more likely to have GAD than males (8.0 vs 1.6 percent; p=0.001; adjusted odds ratio [OR], 6.6; 95 percent CI, 2.0 to 21.5; p=0.002).
In contrast, females with MDD were significantly less likely to have high blood pressure than their male counterparts (12.7 vs 26.5 percent; p=0.033; adjusted OR, 0.2; 0.1 to 0.7; p=0.006).
Males and females with MDD had comparable risks of obsessive compulsive disorder (adjusted OR, 1.0; 0.3 to 3.0; p=0.954), alcohol dependence (adjusted OR, 4.5; 0.4 to 51.3; p=0.222), respiratory conditions (adjusted OR, 1.0; 0.4 to 2.4; p=0.957), chronic pain (adjusted OR, 1.6; 0.7 to 3.7; p=0.223) and cardiovascular diseases (adjusted OR, 0.1; 0.01 to 1.1; p=0.061), among other chronic conditions.
Though none of the trends were significant, females had a slightly later age of MDD onset at 28.3 years compared to 27.5 years in males (p=0.706). Treatment gap was also lower in females than in males (67.6 vs 75.3 percent; p=0.290).
Severity of impairment, measured by the Sheehan Disability Scale and the Hamilton Rating Scale for Depression, was better for females, with the difference being borderline significant (p=0.061).
The study participants were selected from the Singapore Mental Health Study and were screened for the presence of MDD according to the World Health Organization Composite International Diagnostic Interview. Participant history of chronic medical conditions was also determined through interviews.
“The importance of establishing early detection and screening systems in various settings, including educational institutions and general medical practices, is key and could include innovative measures, such as the internet or telephone-based therapy,” researchers said.