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

Abstract

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.

Depression Symptom Severity and Cardiorespiratory Fitness in Healthy and Depressed Adults: A Systematic Review and Meta-Analysis

“…If the prevalence of somatic symptoms in men with depressive symptoms is higher than that in women, this would partially explain the stronger correlation between depression symptom severity and CRF in men in this meta-analysis. However, women have been reported to exhibit more and stronger somatic symptoms than men, in both community populations [75,76] and clinical populations [77,78], although this finding is inconsistent, since other studies have failed to confirm this difference, both in community settings [79,80] and clinical settings [81]. Nevertheless, to the best of our knowledge, there are no studies reporting more or stronger somatic symptoms in men than in women; therefore, this factor does not seem to play a significant role in the sex differences noted in the correlation between depression symptom severity and CRF.…”

Psychometric properties of the Beck Depression Inventory-II: a comprehensive review

“…8,31 Conversely, somatic items such as change in sleeping pattern and in appetite also presented low scores for non-clinical samples. The hypothesis of gender differences in somatic symptoms 132 was not supported by Delisle et al, 68 who showed that the experience and reporting of somatic symptoms could explain merely a small portion of discrepancy in depressed patients. Testing the hypothesis of whether individual baseline depressive symptoms in the interest-activity domain would predict outcome, the items pessimism and loss of energy were found to be independent predictors of both remission and response in the treatment setting.…”

Avaliação dos sintomas depressivos somáticos e afetivo-cognitivos de pessoas vivendo com HIV/AIDS

“…(12,13) In the same perspective, there are studies that suggest that female vulnerability to depression is also associated with socioeconomic disadvantages (4) and lack of social support. (7) In addition, other authors argue that women are more prone to experiencing negative social determinants, assuming a disproportional load in care delivery, and mostly correspond to a low and middle-income population, besides the accumulation of housework and child raising activities.…”

“…(10) In addition, in other studies, it has been reported that the prevalence of depression among PLHA is two to three times higher when compared to the general population. (11,12) Nevertheless, the population living with HIV/Aids consists of several groups with socioeconomic differences and peculiar behavioral characteristics. (8) Therefore, these differences need to be understood.…”

“…These studies (11,12) appointed variations between men and women with major depressive disorder in terms of perceived depressive symptoms, as measured by the Beck Depression Inventory.…”