Alternative symptom assessment leveled depression rates among sexes
Depression scales that include traditional and alternative symptoms found women and men experience depression at similar rates, according to a subanalysis of the National Comorbidity Survey Replication.
Although women are diagnosed with depression at twice the rate of men, the analysis also found that diagnoses based on only alternative symptoms resulted in higher rates for depression in men.
Lisa A. Martin, PhD, of the women’s and gender studies and health policy studies at the University of Michigan, and colleagues developed two scales for evaluating depression in 5,692 adults.
“When men are depressed they may experience symptoms that are different than what is included in current diagnostic criteria,” Martin said in a press release.
To accommodate for those differences, the researchers utilized the Male Symptoms Scale (MSS), which assessed for male-associated expressions of depression, including:
- Anger attacks or aggression;
- Sleep disturbance;
- Alcohol and other drug abuse;
- Risk-taking behavior;
- Stress; and
- Loss of interest in activities.
The Gender Depression Scale (GIDS) evaluated patients based on each of the MSS assessments, as well as traditional depression symptoms such as saddened mood, loss of vitality, tiredness, ambivalence, anxiety and complaintiveness.
The study participants each met the DSM-IV criteria for any core disorder. There were more women (n=3,310; 58.5%) than men (2,382; 41.5%) and 73.4% were non-Hispanic white. The median age of the population was 45.2 years.
Overall results of the MSS indicated depression in 23.8% of the study population, with a mean score of 6.06 (out of 8). Depression was found more commonly in men (26.3%) than women (21.9%; P=.007).
“These results suggest that relying only on men’s disclosure of traditional symptoms could lead to an underdiagnosis of depression in men and that clinicians should consider other clues when assessing depression in men,” the researchers wrote.
More men reported anger attacks/aggression, substance abuse and risk-taking behavior, whereas women more frequently reported stress, irritability, sleep disturbance and loss of interest in work, hobbies and personal relationships.
When evaluating the population based on the GIDS analysis, the rates for depression were equalized between men and women. Mild (63.2% men vs. 62% women), moderate (28.3% vs. 28.9%) and severe (8.5% vs. 9.1%) depression did not statistically differ between men and women.
Across the study population, depressed mood, anger and aggression, stress, irritability and anxiety were the most common symptoms.
“Gender is likely to play a role in how men and women conceptualize and experience depression,” the researchers concluded. “Ultimately, the results of this work have the potential to bring significant advances to the field in terms of perception and measurement of depression.”
Disclosure: The researchers report no relevant financial disclosures.