Context:Literature is inconsistent about the role of gender in mediating the relationship between life events and depression.Aim:Our objective was to explore gender differences in patterns and frequencies of stressful life events before onset of a depressive episode.Setting and Design:Cross-sectional study at a tertiary care center.Subjects and Methods:One hundred patients fulfilling Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria for current major depression (50 males and 50 females) were recruited for the study. Structured instruments were used to assess psychiatric comorbidity, episode severity, and stressful life events. We compared the number and frequency of stressful life events between genders and their relationship with demographic and clinical variables.Statistical Analysis Used:Mann–Whitney U-test and Chi-square test.Results:Women with depression were older, more likely to be married (P < 0.01), had lower rates of comorbid panic disorder (P < 0.01) and nicotine dependence (P = 0.016) compared to men. Total stress scores and median number of stressful events in the year before onset of depression were significantly lower in women (P < 0.01). Getting married, job or property-related stressors, and breakup of friendship were more commonly reported stressors among males while more females reported dowry-related issues before symptom onset. In stratified analysis, these gender differences continued to hold good only in those with comorbid dysthymia.Conclusion:There appears to be a sex-specific effect of certain life events on depression. Comorbid dysthymia may play an important role in mediating this differential stress sensitivity across genders.
Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure – a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient’s current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined.
Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure -a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient's current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined.
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