Gender Comparison of the Factors Associated with Clinical Depression: A Descriptive Study in a Teaching Institute of Eastern Nepal

Abstract

Background and Objectives: Possible reasons for different factors and presentations in depression may be sex related Methods: A total of 100 (53 female and 47 male) depression cases (as per the ICD-10 DCR) who came to the out-patient clinic and admitted to the ward of department of Psychiatry of a teaching hospital in eastern Nepal were enrolled after obtaining informed consent during the study period. Patients with severe physical co-morbidity, mental retardation making unable to participate and the age younger than 18 and older than 65 years were excluded. Socio-demographic information, clinical profile and co-morbidities were recorded. Three scales: Hamilton Rating Scale for Depression (HAM-D), Social Readjustment Scale by Holmes and Rahe and Eysenck's Personality Inventory were used to see the severity of depression, the life events and the personality traits respectively. Chi-square test was applied to find out the difference between the genders in different variables. Results: Most of the depressive patients were of age 18-50, with most males educated and females educated to middle level. Source of income for majority of females (45%) was family-income and for males (21%) their own income (p= 0.000). More females had family history of depression, suicide and other psychiatric co-morbidities. More females presented with changes in biorhythm including libido and suicide attempt. Males presented more with mood, physical and behavioral changes. More females had co-morbidity of Anxiety, Migraine and substance use disorder. Prevalence of stressor was similar among males and females though the nature and type varied.This is a hospital based descriptive study conducted among the patients with primary diagnosis of clinical depression coming in psychiatric service of BPKIHS, a multi-specialty teaching hospital in eastern Nepal within 1 year of study period.Out of the life events, value of pregnancy (p= 0.014) and trouble with in-laws (p= 0.000) were more in female; and that of losing spouse (p= 0.408), and sex difficulty (p= 0.044) more in male patients with depression. More male patients were found extroverted and neurotic and female patients socially desirable (p= 0.001). Conclusion: Gender differences are seen in depression cases in bio-psycho-social factors. Identification of particular factorsguides management of all levels in general and in particular in female and male patients.