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Sex differences in lifetime depression rates: fact or artefact?

Published online by Cambridge University Press:  09 July 2009

Kay Wilhelm*
Affiliation:
Mood Disorders Unit, Prince Henry Hospital; and School of Psychiatry, University of New South Wales, Australia
Gordon Parker
Affiliation:
Mood Disorders Unit, Prince Henry Hospital; and School of Psychiatry, University of New South Wales, Australia
*
1Address for correspondence: Dr Kay Wilhelm, Mood Disorders Unit, Prince Henry Hospital, Little Bay, NSW 2036, Australia.

Synopsis

To isolate determinants of any female preponderance in depressive disorder, we earlier selected a sample of young adults, then similar in terms of several potential social determinants of depression and with equivalent rates of lifetime depression. We now report a 10-year review, which initially suggested a female preponderance in DIS-generated RDC and DSM-III lifetime depressive categories. The presence of sex differences in rates of lifetime depression was influenced by the definition of caseness used and the vantage point from which rates were determined. The longitudinal design and earlier corroborative witness reports established, however, clear evidence of instability in prevalence estimates, together with a sex effect on stability. Men were more likely to ‘forget’ episodes, while women were more likely to ‘remember’ episodes that had generally not previously reached ‘case’ criteria. When correction was made for such artefactual influences, a sex difference in lifetime depression rates was no longer evident. Such findings require review in general community samples, and suggest modifications to ‘case’ definition in epidemiological enquiries.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1994

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References

Amenson, C. S. & Lewinsohn, P. M. (1981). An investigation into the observed sex difference in prevalence of unipolar depression. Journal of Abnormal Psychology 90, 113.CrossRefGoogle ScholarPubMed
Angst, J. & Dobler-Mikola, A. (1984). The definition of depression. Psychiatry Research 18, 401406.CrossRefGoogle ScholarPubMed
Bebbington, P., Katz, R., McGuffin, P., Tennant, C. & Hurry, J. (1989). The risk of minor depression before age 65: results from a community survey. Psychological Medicine 19, 393400.Google Scholar
Belle, D. (1980). Who uses mental health facilities? In The Mental Health of Women (ed Guttentag, M., Salasin, S. and Belle, D.), pp. 1127. Academic Press: New York.Google Scholar
Bland, R. C., Orn, H. & Newman, S. C. (1988). Lifetime prevalences of psychiatric disorders in Edmonton. Acta Psychiatrica Scandinavica 77, 2432.CrossRefGoogle Scholar
Blatt, S. J., D'Affliti, J. P. & Quinlan, D. M. (1975). Depressive Experiences Questionnaire. Unpublished report, Department of Psychology, Yale University.Google Scholar
Boyd, J. H. & Weissman, M. M. (1981). Epidemiology of affective disorders: a reexamination and future directions. Archives of General Psychiatry 38, 10391046.CrossRefGoogle ScholarPubMed
Briscoe, M. E. (1982). Sex Differences in Psychological Well-being. Psychological Medicine Monograph Suppl. 1. Cambridge University Press: Cambridge.Google Scholar
Bromet, E. J., Dunn, L. O., Connell, M. M., Dew, M. A. & Schulberg, H. C. (1986). Long-term reliability of diagnosing lifetime major depression in a community sample. Archives of General Psychiatry 43, 435440.CrossRefGoogle Scholar
Burke, J. D. (1986). Diagnostic categorization by the Diagnostic Interview Schedule (DIS): a comparison with other methods of assessment. In Mental Disorders in the Community (ed. Barrett, J. and Rose, R.), pp. 225285. Guilford: New York.Google Scholar
Canino, G. J., Bird, H. R., Shrout, P. E., Rubio-Stipec, M., Bravo, M., Martinez, R., Sesman, M. & Guevara, L. M. (1987 a). The prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry 44, 727735.CrossRefGoogle ScholarPubMed
Canino, G. J., Rubio-Stipec, M., Shrout, P., Bravo, M., Stolberg, R. & Bird, H. R. (1987 b). Sex differences and depression in Puerto Rico. Psychology of Women Quarterly 11, 443459.CrossRefGoogle Scholar
Costello, C. G. & Comrey, A. L. (1967). Scales for measuring depression and anxiety. Journal of Psychology 66, 303313.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P. (1989). ‘The problem of validity in field studies of psychological disorders’ revisited. In The Validity of Psychiatric Diagnosis (ed. Robins, L. N. and Barrett, J. E.), pp. 3553. Raven Press: New York.Google Scholar
Erdman, H. P., Klein, M. H., Greist, J. H., Bass, S. M., Bires, J. K. & Machtinger, P. E. (1987). A comparison of the Diagnostic Interview Schedule and clinical diagnosis. American Journal of Psychiatry 144, 14771480.Google ScholarPubMed
Eysenck, H. J. & Eysenck, S. B. (1964). Manual of the Eysenck Personality Inventory. Hodder and Stoughton: London.Google Scholar
Fendrich, M., Weissman, M. M., Warner, V. & Mufson, L. (1990). Two-year recall of lifetime diagnoses in offspring at high and low risk for major depression. Archives of General Psychiatry 47, 11211127.Google Scholar
Hammen, C. L. & Padesky, C. A. (1977). Sex differences in the expression of depressive responses on the Beck Depression Inventory. Journal of Abnormal Psychology 86, 609614.CrossRefGoogle ScholarPubMed
Harris, T., Surtees, P. & Bancroft, J. (1991). Is sex necessarily a risk factor to depression? British Journal of Psychiatry 158, 708712.Google Scholar
Jenkins, R. (1985). Sex Differences in Minor Psychiatric Morbidity. Psychological Medicine: Monograph Suppl. 7. Cambridge University Press: Cambridge.Google Scholar
Jorm, A. F. (1987). Sex and age differences in depression: a quantitative synthesis of published research. Australian and New Zealand Journal of Psychiatry 21, 4653.CrossRefGoogle ScholarPubMed
Jorm, A. F., Duncan-Jones, P. & Scott, R. (1989). An analysis of the re-test artefact in longitudinal studies of psychiatric symptoms and personality. Psychological Medicine 19, 487493.CrossRefGoogle ScholarPubMed
McLeod, J. D., Turnbull, J. E., Kessler, R. C. & Abelson, J. M. (1990). Sources of discrepancy in the comparison of a lay-administered diagnostic instrument with clinical diagnosis. Psychiatry Research 31, 145159.CrossRefGoogle ScholarPubMed
Myers, J. K., Weissman, M. M., Tischler, G. L., Holzer, C. E., Leaf, P. J., Orvaschel, H., Anthony, J. C., Boyd, J. H., Burke, J. D., Kramer, M. & Stoltzman, R. (1984). Six-month prevalence of psychiatric disorders in three communities: 1980 to 1982. Archives of General Psychiatry 41, 959967.Google Scholar
Nolen-Hoeksema, S. (1987). Sex differences in unipolar depression: evidence and theory. Psychological Bulletin 101, 259282.Google Scholar
Oakley-Browne, M. A., Joyce, P. R., Wells, J. E., Bushnell, J. A. & Hornblow, A. R. (1989). Christchurch psychiatric epidemiology study. Part II. Six-month and other period prevalences of specific psychiatric disorders. Australian and New Zealand Journal of Psychiatry 23, 327340.Google Scholar
Parker, G. (1979). Sex differences in non-clinical depression. Australian and New Zealand Journal of Psychiatry 13, 127132.CrossRefGoogle ScholarPubMed
Regier, D. A., Myers, J. K., Kramer, M., Robins, L. H., Blazer, D. G., Hough, R. L., Eaton, W. W. & Locke, B. Z. (1984). The NIMH Epidemiologic Catchment Area program: historical context, major objectives and study population characteristics. Archives of General Psychology 41, 934941.Google Scholar
Rice, J. P., McDonald-Scott, P., Endicott, J., Coryell, W., Grove, W. M., Keller, M. B. & Altis, D. (1986). The stability of diagnosis with an application to bipolar II disorder. Psychiatry Research 19, 285296.CrossRefGoogle ScholarPubMed
Rice, J. P., Endicott, J., Knesevich, M. A. & Rochberg, N. (1987). The stimulation of diagnostic sensitivity using stability data: an application to major depressive disorder. Psychiatry Research 21, 337345.CrossRefGoogle Scholar
Rice, J. P., Rochberg, N., Endicott, J., Lavori, P. W. & Miller, C. (1992). Stability of psychiatric diagnoses. An application to the affective disorders. Archives of General Psychiatry 49, 824830.Google Scholar
Robins, L. N. (1989). Diagnostic grammar and assessment: translating criteria into questions. Psychological Medicine 19, 5768.CrossRefGoogle ScholarPubMed
Robins, L. N. & Helzer, J. E. (1988). New diagnostic instruments. In Handbook of Social Psychiatry (ed. Henderson, S. and Burrows, G.), pp. 312. Elsevier: Sydney.Google Scholar
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity. Archives of General Psychiatry 38, 381389.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Ratcliff, K. S. & Seyfried, W. (1982). Validity of the Diagnostic Interview Schedule, Version II: DSM-III diagnoses. Psychological Medicine 12, 855870.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, G., Burke, J. D. & Regier, D. A. (1984). Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry 41, 949958.CrossRefGoogle ScholarPubMed
Rosenberg, M. (1965). The Measurement of Self-Esteem. Society and the Adolescent Self-image. Princeton University Press: Princeton, New Jersey.CrossRefGoogle Scholar
Verbrugge, L. M. (1985). Gender and health: an update on hypotheses and evidence. Journal of Health and Social Behavior 26, 156182.CrossRefGoogle ScholarPubMed
Warshaw, M. G., Klerman, G. L. & Lavori, P. W. (1991). Are secular trends in major depression an artifact of recall? Journal of Psychiatric Research 25, 141151.Google Scholar
Weissman, M. M. & Klerman, G. L. (1977). Sex differences and the epidemiology of depression. Archives of General Psychiatry 34, 98111.CrossRefGoogle ScholarPubMed
Weissman, M. M. & Myers, J. K. (1978). Affective disorders in a US urban community. The use of Research Diagnostic Criteria in an epidemiological survey. Archives of General Psychiatry 35, 13041311.CrossRefGoogle Scholar
Weissman, M. M., Leaf, P. J., Holzer, C. E., Myers, J. K. & Tischler, G. L. (1984). The epidemiology of depression: an update on sex differences in rates. Journal of Affective Disorders 7, 179188.CrossRefGoogle ScholarPubMed
Weissman, M. M., Leaf, P. J., Tischler, G. L., Blazer, D. G., Karno, M., Bruce, M. L. B. & Florio, L. P. (1988). Affective disorders in five United States communities. Psychological Medicine 18, 141153.CrossRefGoogle ScholarPubMed
Wells, J. E., Bushnell, J. A., Hornblow, A. R., Joyce, P. R. & Oakley-Browne, M. A. (1989). Christchurch psychiatric epidemiology study. Part I. Methodology and lifetime prevalence for specific psychiatric disorders. Australian and New Zealand Journal of Psychiatry 23, 315326.CrossRefGoogle ScholarPubMed
Wilhelm, K. & Parker, G. (1989). Is sex necessarily a risk factor to depression? Psychological Medicine 19, 401413.CrossRefGoogle ScholarPubMed
Williams, J. B. W. & Spitzer, R. L. (1982). Research diagnostic criteria and DSM-III: an annotated comparison. Archives of General Psychiatry 39, 12831289.CrossRefGoogle ScholarPubMed
Wilson, P. H. (1979). Behavioural and Pharmacological Treatment of Depression. Unpublished PhD thesis, University of New South Wales.Google Scholar
Young, M. A., Scheftner, W. A., Fawcett, J. & Klerman, G. L. (1990). Gender differences in the clinical features of unipolar major depressive disorder. Journal of Nervous and Mental Disease 178, 200203.CrossRefGoogle ScholarPubMed