FACTSHEET: GENDER AND DEPRESSION

Update: 31-05-2011
FACTSHEET: GENDER AND DEPRESSION
Epidemiology
• In adults and the elderly, depression is two times more prevalent in
women than in men: 10%-25% of women are at risk of developing
depression in the course of their lives, as against 5%-12% of men.
(Nationaal Kompas Volksgezondheid (RIVM and Goldstein).
• In young people between the ages of 13-17, depression is three times
more prevalent in girls than in boys (Nationaal Kompas Volksgezondheid
(RIVM))
Risk Factors
Individual Susceptibility
• Women with physical, emotional, and sexual abuse in their medical
history and women with current or past violence in their partner
relationship are at much greater risk of developing depression (Hegarty);
37%-41% of women visiting their GP have experienced intimate partner
violence at some point (Lo Fo Wong).
• Relationship issues and problems with children are risk factors for
depression in women more than in men, with the lack of a supportive
network of significant relations providing an additional risk (Accortt,
Buis, Bromberger, and Nicolai).
Social Factors
• People with low Socio-Economic Status (SES) are more at risk of developing
depression than people with greater economic success. Women are exposed
to chronic stressors such as low income, crime, violence, their children’s
illnesses, and assaults more than men (Bromberger). At-risk groups for
depression are: low-SES single mothers; working mothers in low-grade
positions; single elderly women lacking a social support network (Möller-
Leimkühler).
Hormonal Factors
• In approximately 5% of women, hormonal imbalances during the fertile
period cause PMDD, the serious variant of PMS (Accort and Thorpe).
• During menopause, women who have experienced depression
before are more vulnerable to developing depression once again
(Noble).
• Twenty per cent of pregnant women develop symptoms of depression, with
one in ten developing genuine depression (Yonkers).
• Ten to fifteen per cent of women develop postnatal depression
(Kornstein). Women who have had postnatal depression before are at
25% risk of developing such a depression once again (Marcus).
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Update: 31-05-2011
Gender Roles
• Women are at greater risk of getting depressed because they
value intimate relationships (Accortt).
• Girls have a negative body image more often than boys (Seiffge-Krenke).
• Men identify physical diseases, problems at work, and unemployment as
causes of depression more often than women (Angst).
• Single men or men who survive their partners are particularly vulnerable for
• depression; women appear to be more resilient later in life when they
have been widowed or live alone (Goldstein).
• Widowers are more at risk of depression than widows. Widowers who rely
heavily on their children are especially at risk. Widows tend to have a more
extensive social network involving relatives, neighbours, and friends
(Stevens).
Co-morbidity
• Insomnia and depression often go together and occur in conjunction more
in women than in men (Krystal).
• Depression causes a sharp increase in cardiovascular diseases in women,
and cardiovascular diseases cause more severe depression in women than
in men (Möller- Leimkühler).
Presentation and Diagnostics
• In men, depression is more often masked by use of alcohol and drugs or
compulsive- obsessive behaviour than in women (Orengo).
• In women, anxiety and panic disorders and eating disorders make
diagnosing depression more difficult (Have). In women, the
combination of anxiety and depression is twice as prevalent as in
men (Zender).
• More men (52%) avoid help-seeking than women (41%) (Angst). Men
are less inclined to report depressive symptoms or seek professional
help than women (Orengo).
• Many men who are depressed are not identified as such and are not
treated. This may be related to a male gender role that fosters an attitude
of stoicism and suppressed emotion (Accortt).
Coping
• Men tend to avoid feelings of not being in control by rationalizing or
denying them (Kilmartin). When they are depressed, men tend to look for
external causes outside their sphere of influence, whereas women tend to
blame themselves (Cochran, Have, and Buis). Women lack a task- or
action-oriented approach to stressful situations, which may cause
depression (Bromberger). Men more often tend to take their mind off
things by engaging in sports (Angst).
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Update: 31-05-2011
• Boys develop more effective coping strategies to negative events
in their lives than girls. Boys take their mind off things in stressful
situations; girls and women tend to go for a more brooding coping style
and appear to be more self-focused in stressful situations (Accortt,
Bromberger, and Seiffge-Krenke).
Disease Course
• Although depressed women make more suicide attempts than men, the
number of successful suicides is four times higher in men than in
women (Orengo).
• Suicide accounts for 20% of post-partum deaths (Lindahl).
Consequences
• Women feel the effects of depression in quality of sleep and general health
more than men (Angst).
• Depressed men are affected by their reduced capacity for work more than
women (Angst).
Literature
• Accortt, E. E., M. P. Freeman, and J. J. Allen, "Women and major depressive disorder:
• clinical perspectives on causal pathways," J.Womens Health (Larchmt.) 17 (10): 1583-
• 1590 (2008).
• Angst, J. et al., "Gender differences in depression. Epidemiological findings from the
• European DEPRES I and II studies," Eur.Arch.Psychiatry Clin.Neurosci. 252 (5): 201-
• 209 (2002).
• Bromberger, J. T., "A psychosocial understanding of depression in women: for the primary
care physician," J.Am.Med.Womens Assoc. 59 (3): 198-206 (2004).
• Buis, W., “Depressie”, in: Sekseverschillen in ziekte en gezondheid. Lagro-Janssen, T. en
• G. Noordenbos (red.), SUN: Nijmegen (1997).
• Cochran, S.V. and F.E. Rabinowitz, Men and depression: clinical and empirical
perspectives. San Diego: Academic Press, 2000
• Goldstein, R. D. and A. M. Gruenberg, "Major Depressive Disorder in the older adult:
• implications for women," J.Women Aging 19 (1-2): 63-77 (2007).
• Have, M. ten, C. Schoemaker, en W. Vollebergh, “Genderverschillen in psychische
stoornissen, consequenties en zorggebruik. Resultaten van de Netherlands Mental Health
Survey and Incidence Study (NEMESIS),” Tijdschrift voor Psychiatrie 44 (6): 367-375
(2002).
• Hegarty, K. et al., "Association between depression and abuse by partners of women
attending general practice: descriptive, cross sectional survey," BMJ 328 (7440): 621-624
(2004).
• Kilmartin C., “ Depression in men: communication, diagnosis and therapy”. J Men’s Health
2:96-99 (2005).
• Kornstein, S. G., "The evaluation and management of depression in women across the life
span," J.Clin.Psychiatry 62 Suppl 24: 11-17 (2001).
• Krystal, A. D., "Depression and insomnia in women," Clin.Cornerstone. 6 Suppl 1B: S19-
S28 (2004).
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Update: 31-05-2011
• Lindahl, V., J. L. Pearson, and L. Colpe, "Prevalence of suicidality during
pregnancy and the postpartum," Arch.Womens Ment.Health 8 (2): 77-87
(2005).
• Lo Fo Wong, S., F. Wester, S.S.L. Mol and T.L.M. Lagro-Janssen, “Increased
awareness of intimate partner abuse after training: a randomized controlled trial”. British
Journal of General Practice 56(525):249-57 (2006).
• Marcus, S. M. and J. E. Heringhausen, "Depression in childbearing women: when
depression complicates pregnancy," Prim.Care 36 (1): 151-65, ix (2009).
• Möller-Leimkühler, A. M., "Gender differences in cardiovascular disease and comorbid
depression," Dialogues.Clin.Neurosci. 9 (1): 71-83 (2007).
• Nationaal Kompas Volksgezondheid (RIVM) – geraadpleegd: 28 jan. 2010. URL:
• http://www.rivm.nl/vtv/object_class/kom_depressie.html
• Nicolai, N. Vrouwenhulpverlening & psychiatrie. Babylon-De Geus: Amsterdam, 1997
• Noble, R. E., "Depression in women," Metabolism 54 (5 Suppl 1): 49-52 (2005). Orengo, C.
A., G. Fullerton, and R. Tan, "Male depression: a review of gender concerns and
testosterone therapy," Geriatrics 59 (10): 24-30 (2004).
• Seiffge-Krenke, I., "[Depression in children and adolescents: prevalence, diagnosis,
etiology, gender differences and therapeutic approaches],"
Prax.Kinderpsychol.Kinderpsychiatr. 56 (3): 185-205 (2007).
• Stevens, N., “Gender and adaptation to widowhood in later life.” Ageing Society 15:37-58
(1995).
• Thorpe, L. et al., "Clinical guidelines for the treatment of depressive disorders. VI. Special
populations," Can.J.Psychiatry 46 Suppl 1: 63S-76S (2001).
• Yonkers, K. A., "Special issues related to the treatment of depression in women,"
• J.Clin.Psychiatry 64 Suppl 18: 8-13 (2003).
• Zender, R. and E. Olshansky, "Women's mental health: depression and anxiety,"
• Nurs.Clin.North Am. 44 (3): 355-364 (2009).
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