Gender Differences in Clinical Features of Depressed Outpatients: Preliminary Evidence for Subtyping of Depression?

Dekker, Jack; Koelen, Jurrijn; Peen, Jaap; Schoevers, Robert A.; Wijk, Cecile Gijsbers-van

doi:10.1300/j013v46n04_02

Cited by 28 publications

(24 citation statements)

References 29 publications

(51 reference statements)

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“…Our study, focusing on a large number of somatic complaints, indicates that changes in appetite are not the only gender difference, and that a larger proportion of women had over 5 unexplained somatic symptoms. Female gender has also been seen to be closely associated with a somatic presentation of depression in epidemiological studies [48] . Analyzing data from the National Comorbidity Survey [49] , Silverstein [24,50] demonstrated gender differences in 'somatic depression' but not in 'pure depression'.…”

Section: Discussionmentioning

confidence: 99%

Unexplained Somatic Symptoms during Major Depression: Prevalence and Clinical Impact in a National Sample of Italian Psychiatric Outpatients

Perugi

Canonico²,

Carbonato

et al. 2011

Psychopathology

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Background: The aim of this study was to explore the prevalence and impact of unexplained somatic symptoms during major depression. Sampling and Methods: A total of 560 consecutive outpatients with a major depressive episode according to the DSM-IV (text revision) were evaluated in 30 psychiatric facilities throughout Italy. ‘Unexplained’ somatic symptoms were evaluated using the 30-item Somatic Symptoms Checklist (SSCL-30). Somatic symptoms were considered explained if they were best accounted for as coming from a concomitant physical illness or side effects. Patients evaluated their own mood symptomatology using the Zung questionnaires for depression and anxiety and the Hypomania Checklist-32. Results: According to the SSCL-30, only 90 subjects (16.1%) had no unexplained somatic symptoms, while 231 (41.3%) had 1–5 unexplained symptoms and 239 (42.7%) had more than 5. Asthenia was the most commonly observed unexplained somatic symptom (53% of patients). Unexplained somatic symptoms were more common in females and among those suffering from major depression and depression not otherwise specified rather than in patients with recurrent major depression and bipolar disorders. No relationship between unexplained somatic symptoms and hypomanic features was observed. Conclusions: The presence of a large number of unexplained somatic symptoms is associated with more severe depression and higher rates of misdiagnosis and inappropriate treatment.

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Section: Discussionmentioning

confidence: 99%

Unexplained Somatic Symptoms during Major Depression: Prevalence and Clinical Impact in a National Sample of Italian Psychiatric Outpatients

Perugi

Canonico²,

Carbonato

et al. 2011

Psychopathology

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“…Germane to studies of gender-specific behavior and depression, previous reports have found depressed women more often have an anxious and atypical symptom profiles, endorsing more somatic and affective symptoms compared to men [55]–[59]. Depressed women also display a higher tendency to ruminate about problems [60], higher stress, and lower fulfillment associated with traditional gender roles [61].…”

Section: Discussionmentioning

confidence: 99%

Gender-Specific Effects of Depression and Suicidal Ideation in Prosocial Behaviors

et al. 2014

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BackgroundProsocial behaviors are essential to the ability to relate to others. Women typically display greater prosocial behavior than men. The impact of depression on prosocial behaviors and how gender interacts with those effects are not fully understood. We explored the role of gender in the potential effects of depression on prosocial behavior.MethodsWe examined prosocial behaviors using a modified version of the Trust Game in a clinical population and community controls. Study participants were characterized on the severity of depression and anxiety, presence of suicidal ideation, history of childhood trauma, recent stressful life events, and impulsivity. We correlated behavioral outcomes with gender and clinical variables using analysis of variance and multiple regression analysis.ResultsThe 89 participants comprised four study groups: depressed women, depressed men, healthy women and healthy men (n = 16–36). Depressed men exhibited reciprocity more frequently than healthy men. Depression induced an inversion of the gender-specific pattern of self-centered behavior. Suicidal ideation was associated with increased reciprocity behavior in both genders, and enhancement of the effect of depression on gender-specific self-centered behavior.ConclusionsDepression, particularly suicidal ideation, is associated with reversal of gender-specific patterns of prosocial behavior, suggesting abnormalities in sexual hormones regulation. This explanation is supported by known abnormalities in the hypothalamus-pituitary-adrenal and hypothalamus-pituitary-gonadal axes found in depression.

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“…Many studies have examined whether men and women report somatic symptoms of depression differently or whether the number of somatic symptoms reported by men and women might explain gender differences in depression rates and severity [8], [13]–[26]. Since women have higher rates of depression than men, it would be expected that women would have higher cognitive/affective and somatic symptoms than men on average, but that the composition of symptoms among men and women would be similar.…”

Section: Introductionmentioning

confidence: 99%

“…Many other studies have examined whether there are gender differences in the endorsement of individual depressive symptoms [8], [13]–[20], [23]–[26]. The results of those studies, however, have been inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Revisiting Gender Differences in Somatic Symptoms of Depression: Much Ado about Nothing?

et al. 2012

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BackgroundWomen have a higher prevalence of Major Depressive Disorder (MDD) and report more severe depressive symptoms than men. Several studies have suggested that gender differences in depression may occur because women report higher levels of somatic symptoms than men. Those studies, however, have not controlled or matched for non-somatic symptoms. The objective of this study was to examine if women report relatively more somatic symptoms than men matched on cognitive/affective symptoms.MethodsMale and female patients receiving treatment for MDD in outpatient psychiatric clinics in New Jersey and Pennsylvania, USA were matched on Beck Depression Inventory-II (BDI-II) cognitive/affective symptom scores. Male and female BDI-II somatic symptom scores were compared using independent samples 2-tailed t-tests.ResultsOf 472 male and 1,026 female patients, there were 470 male patients (mean age = 40.1 years, SD = 15.1) and 470 female patients (mean age = 43.1 years, SD = 17.2) successfully matched on BDI-II cognitive/affective symptom scores. Somatic symptoms accounted for 35% of total BDI-II scores for male patients versus 38% for matched female patients. Female patients had somatic symptom scores on average 1.3 points higher than males (p<.001), equivalent to 4% of the total BDI-II scores of female patients. Only 5% of male patients and 7% of female patients scored 2 or higher on all BDI-II somatic symptom items.ConclusionsGender differences in somatic scores were very small. Thus, differences in the experience and reporting of somatic symptoms would not likely explain gender differences in depression rates and symptom severity.

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Gender Differences in Clinical Features of Depressed Outpatients: Preliminary Evidence for Subtyping of Depression?

Abstract: It may be useful to delineate syndrome of somatic complaints in the context of depression that is more prevalent among women.

Cited by 28 publications

References 29 publications

Unexplained Somatic Symptoms during Major Depression: Prevalence and Clinical Impact in a National Sample of Italian Psychiatric Outpatients

Unexplained Somatic Symptoms during Major Depression: Prevalence and Clinical Impact in a National Sample of Italian Psychiatric Outpatients

Gender-Specific Effects of Depression and Suicidal Ideation in Prosocial Behaviors

Revisiting Gender Differences in Somatic Symptoms of Depression: Much Ado about Nothing?

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