Symptom endorsement in men versus women with a diagnosis of depression: A differential item functioning approach

Abstract

. (2016). Symptom endorsement in men versus women with a diagnosis of depression: A differential item functioning approach. International Journal of Social Psychiatry, 62 (6), 549-559.Symptom endorsement in men versus women with a diagnosis of depression: A differential item functioning approach Abstract Background: There is some evidence that, in contrast to depressed women, depressed men tend to report alternative symptoms that are not listed as standard diagnostic criteria. This may possibly lead to an under-or misdiagnosis of depression in men. Aims: This study aims to clarify whether depressed men and women report different symptoms. Methods: This study used data from the 2007 Australian National Survey of Mental Health and Wellbeing that was collected using the World Health Organization's Composite International Diagnostic Interview. Participants with a diagnosis of a depressive disorder with 12-month symptoms (n = 663) were identified and included in this study. Differential item functioning (DIF) was used to test whether depressed men and women endorse different features associated with their condition. Results: Gender-related DIF was present for three symptoms associated with depression. Depressed women were more likely to report 'appetite/weight disturbance', whereas depressed men were more likely to report 'alcohol misuse' and 'substance misuse'. Conclusion: While the results may reflect a greater risk of cooccurring alcohol and substance misuse in men, inclusion of these features in assessments may improve the detection of depression in men, especially if standard depressive symptoms are under-reported.

“The Masks We Wear”: A Qualitative Study of Suicide in Australian Farmers

“…Features of this subtype include: a sudden and periodically lowered stress tolerance in otherwise stress resistant men; impulsive‐aggressive or psychopathic personality disorder in otherwise nonpsychopathic persons; and suddenly occurring endorphin‐ or serotonin‐related behavior, such as alcohol and other drug abuse or workaholism in otherwise nonabusive men . Men appear to mask depression by atypical symptoms such as anger, hostile‐aggressive‐abusive behavior, or irritability, which may lead to depression being underdiagnosed and undertreated in men . Mental health problems were often comorbid physical conditions.…”

“…40 Men appear to mask depression by atypical symptoms such as anger, hostile-aggressive-abusive behavior, or irritability, 40 which may lead to depression being underdiagnosed and undertreated in men. 42 Mental health problems were often comorbid physical conditions. Research has indicated significant associations between somatic and psychological symptoms and depression in farmers, 43 and specific physical illnesses (eg, pain and arthritis) and functional disability with suicidal behaviors in older adults.…”

Predictors of receiving a diagnosis, referral and treatment of depression in people on antiretroviral therapy in South African primary care: a secondary analysis of data from a randomised trial

“…This over‐representation of women can be due to several factors, including that women are more likely to receive ART than men [50,51]. Women tend to present with affective symptoms while men tend to self‐medicate depressive symptoms with substances [52], which is not assessed using the PHQ‐9. No clinic characteristics were consistently associated with gaps in receiving care.…”

Men's mental health: coming out of the closet?

“…2 It may also be that some of the symptoms of depression in men -such as alcohol misuse or antisocial behaviour -are not diagnosed as such, 3 leading to the suggestion that a different set of diagnostic criteria should be used for men. 4 The Royal College of Psychiatrists suggests that, in fact, men suffer from depression to the same extent as women. There are several specific mental health issues where the burden on men is very clear.…”