Is excess mortality higher in depressed men than in depressed women? A meta-analytic comparison

Abstract

a b s t r a c tBackground: It is not well-established whether excess mortality associated with depression is higher in men than in women. Methods: We conducted a meta-analysis of prospective studies in which depression was measured at baseline, where mortality rates were reported at follow-up, and in which separate mortality rates for men and women were reported. We conducted systematic searches in bibliographical databases and calculated relative risks of excess mortality in men and women. Results: Thirteen studies were included. Among the people with depression, excess mortality in men was higher than in women (RR¼1.97; 1.63-2.37). Compared with non-depressed participants, excess mortality was increased in depressed women (RR¼ 1.55; 95% CI: 1.32-1.82), but not as much as in men (RR¼ 2.04; 95% CI: 1.76-2.37), and the difference between excess mortality in men was significantly higher than in women (p o0.05). Conclusions: Excess mortality related to depression is higher in men than in women. Although the exact mechanisms for this difference are not clear, it may point at differential or more intensified pathways leading from depression to increased mortality in depressed men compared to women.

Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada

“…While our results found women demonstrated the largest losses of life expectancy, other studies on mortality risk and life expectancy according to depression status found that men had the greater mortality risk or loss of life expectancy. 11,17,19,20 However, most of these studies tended to focus on elderly or older adult populations that likely have a different risk profile than the full adult population. Indeed, Shah et al 41 assessed both sex and age differences in the association of depression with mortality and found significant depression-age-sex interactions: mortality risk increased for men as age increased above 55 years while the inverse was found for women.…”

“…10 Potential mechanisms for the relationship between depression and physical disease include immune and endocrine dysregulation and inflammatory processes. 11 Depression has also been associated with an increased risk of mortality in general community populations, as well as in patient populations with chronic illnesses such as coronary heart disease, cancer, diabetes and stroke. 11 There are likely reciprocal effects between depression and disease, with depression being a risk factor for, and a sequela of, disease.…”

“…11 Depression has also been associated with an increased risk of mortality in general community populations, as well as in patient populations with chronic illnesses such as coronary heart disease, cancer, diabetes and stroke. 11 There are likely reciprocal effects between depression and disease, with depression being a risk factor for, and a sequela of, disease. 11 Summary measures of population health using the Global Burden of Disease methodology 1,[12][13][14][15] have ranked depression very high on the list of health conditions contributing to the global and national burden of disease, particularly in terms of losses due to disability.…”

“…11 There are likely reciprocal effects between depression and disease, with depression being a risk factor for, and a sequela of, disease. 11 Summary measures of population health using the Global Burden of Disease methodology 1,[12][13][14][15] have ranked depression very high on the list of health conditions contributing to the global and national burden of disease, particularly in terms of losses due to disability. Major depressive episode is the second leading cause of years lived with disability globally 1 as well as in the United States, 12 the United Kingdom, 13 China 14 and Canada.…”

Description du fardeau de la dépression sur la santé de la population au Canada : utilisation de l’espérance de vie ajustée en fonction de la santé

“…Il a également été prouvé, outre ces effets négatifs directs, que la dépression augmente le risque de coronaropathie 7 , d'accident vasculaire cérébral 8 et de cancer 9 , ainsi qu'un déclin du fonctionnement physique 10 . Les mécanismes potentiels de la relation entre la dépression et la maladie physique relèvent notamment du dérèglement des systèmes immunitaire et endocrinien et des processus inflammatoires 11 . La dépression a aussi été associée à un risque accru de mortalité, que ce soit dans l'ensemble de la population ou chez les patients atteints de maladies chroniques comme les coronaropathies, le cancer, le diabète ou les AVC 11 .…”