Gender differences in the psychopathology of depressed inpatients

Abstract

In the last few years there has been increased scientific effort to describe the gender-specific psychopathological features of depression. Until now these studies have not been entirely conclusive, which could be the result of methodological difficulties. This report investigates sex differences in the symptom presentation in an inpatient population: 104 female and 113 male patients suffering from a depressive episode according to ICD-10 were admitted to the inpatient treatment at the Department of General Psychiatry in Vienna. A psychopathological rating according to the standardized documentation system of the AMDP (Association for Methodology and Documentation in Psychiatry) was performed at admission and discharge. At admission into the hospital women tended to show more affective lability (p = 0.025), whereas men had higher scores in affective rigidity (p = 0.032), blunted affect (p = 0.002), decreased libido (p = 0.028), hypochondriasis (p = 0.016) and hypochondriac delusions (p = 0.039). At discharge from the hospital women had significantly higher scores in dysphoria (p = 0.010), while men were more prone to have compulsive impulses (p = 0.030). Although our results were obtained in a selected sample of inpatients at a university hospital, they are indicative of psychopathological differences between men and women in the core symptoms of depression. These differences may influence diagnostic practice and gender specific treatment of depression.

Anger Attacks in Depression – Evidence for a Male Depressive Syndrome

“…One of the drawbacks of many of the previous studies was that only a narrow scope of typical depressive symptoms was assessed. Recently, two studies have been published evaluating psychopathology with the AMDP system [29, 43]. However, both studies have yielded only subtle gender differences in the symptom pattern, which suggested an exaggeration or distortion of gender-bound role behavior during depression, but failed to entirely confirm the hypothesis of a distinct male depression, which may be due to insensitivity of the AMDP items.…”

“…As established by Fava et al [8], subjects were classified as having anger attacks, if they exhibited the following criteria during their last depression: a 6-month baseline of irritability in combination with a tendency to overreact, at least one anger attack per month and at least 4 additional autonomic arousal symptoms and behavioral outburst. According to our prior study [29], we assumed that there would not be any sex differences in total HAD and BDI scores. The secondary objective of our study was an exploratory analysis of gender differences in regard to the items of the GMDS and the ADDS.…”

“…Mean age of our patients was 50.3 ± 16.0 years. An analysis of gender differences in this sample in regard to the standardized psychopathological documentation system of the Association for Methodology and Documentation in Psychiatry (AMDP) [28] has been described elsewhere [29]. …”

Estudos psicopatológicos na psiquiatria atual

“…Frequentemente, a análise e discussão dos resultados desse tipo de trabalho os comparam a resultados obtidos por estudos junto a populações diferentes (neste caso, estudos com pacientes de países ocidentais). Contudo, enquanto nesses trabalhos o objetivo principal é a "descrição", sendo a "comparação" permitida um desdobramento, estudos como o de Turkel et al (2004) e o de Winkler et al (2004) são mais especificamente dirigidos a este segundo propósito e já incluem duas populações distintas em suas avaliações. Nestes dois casos, especificamente, a atenção se dirige a possíveis diferenças sintomáticas do transtorno obsessivo compulsivo e quadros depressivos, respectivamente, em populações feminina e masculina.…”

Paternal Postnatal Depression - a review

“…Other symptoms of depression in fathers may include: withdrawal from social interactions, indecisiveness, cynicism and irritability, and also avoidance behavior, alcohol abuse, drug use, extramarital sex and violent behavior towards the partner. Male emotions might occur more as fear or anger than sadness [11]. When no uniform assessment criteria are available, the symptoms of paternal postnatal depression may be misunderstood.…”