Gender Differences in Severity, Symptomatology and Distribution of Melancholia in Major Depression

Abstract

Background: Studies of gender differences in the clinical presentation of depression have provided divergent results. This study aimed at analyzing gender differences in severity, symptomatology and distribution of melancholia in major depression. Sampling and Methods: The study comprised 930 in- and out-patients (652 women, 278 men) from 6 randomized controlled trials. All patients fulfilled DSM-III or DSM-III-R criteria for major depression. The 17-item Hamilton Depression Scale (HDS) was applied to all patients. A multi-axial evaluation was completed using the Newcastle 1 Depression Rating Scale from 1965 for melancholia (N1) in a subsample of patients (n = 439). A factor analysis on the HDS was performed. Non-parametric statistical tests were used and only gender differences greater than 20% were considered clinically relevant. Results: The median on the HDS total score was 22 and the median number of symptoms was 13 for both men and women. Presentation of specific symptoms was similar for men and women. The factor analysis revealed no gender differences, and neither did analyses on symptoms of Axes II and IV. According to the N1, 80% of the men and 66% of the women suffered from melancholic depression (p = 0.004). Conclusions: In a large and broad sample of in- and out-patients with major depression, the severity and symptomatology of depression were similar for men and women. Melancholic depression was significantly more frequent among male than female patients. Inclusion and exclusion criteria in the randomized controlled trials provided a selected group of patients, which limited the generalisability of the results to an exclusive subgroup of patients treated for depression in routine clinical practice.

A three-factor model of the MADRS in major depressive disorder

“…These findings further suggest that the symptoms of MDD are composed of independent clusters. The ef fects of age and gender on depressive symptomatology have been inconclusive Hildebrandt et al, 2003;Koenig et al, 1993;Silverstein, 1999;Stage et al, 2001;Wallace and Pfohl, 1995]. For instance, the more vegetative symptoms in females than in males presented here was observed in one study [Silverstein, 1999], but not in another [Hildebrandt, 2003].…”

Gender differences in symptomatic profiles of depression: Results from the São Paulo Megacity Mental Health Survey

“…Sobin and Sackeim (1997) conducted a literature review and discussed that in several studies gender appears to be an important determinant of the manifestation of psychomotor symptoms, with men presenting more psychomotor retardation than women, and women more agitation than men (Avery and Silverman, 1984;Hamilton, 1967;Winokur et al, 1973). Nevertheless, these findings have been contested by Schrijvers et al (2008), who reported studies that found an opposite association between gender and psychomotricity (Khan et al, 2002;Kornstein et al, 2000), and others that did not observe any difference (Hildebrandt et al, 2003a(Hildebrandt et al, , 2003bPier et al, 2004;Scheibe et al, 2003). In our study, male gender has clearly influenced the expression of psychomotor symptoms.…”

Gender Differences among Patients with a Single Depressive Episode

“…Many of the studies on gender differences in depression are part of randomized controlled trials or performed in subgroups of patients with recurrent, chronic or psychotic depression [36] , thereby reducing the generalisability of the results, though greater severity of depressive symptoms has also been reported in large community studies [37] . Further, no study of gender differences in depression has presented data on non-participants.…”