Masculine depression and its problem behaviors: use alcohol and drugs, work hard, and avoid psychiatry!

Abstract

The gender role influences vulnerability to mental illness. Substance use, even critical in scale, is perceived as masculine, just like hard (over-)work, while not seeking help. With the ongoing separation between gender and sex, masculine norms become more relevant also to females’ mental health. The male depression concept highlights the role of male symptoms in affective disorders. However, the empirical evidence is still limited. Here, we use the denomination ‘masculine depression’ to open the category for female patients and tested substance use patterns, health services’ utilization, and working hours as predictors in a case–control study of 163 depressed in-patients (44% women; masculine vs. non-masculine depression according to a median split of the Male Depression Rating Scale-22) and 176 controls (51% women). We assessed higher depression severity in patients with masculine (vs. non-masculine) depression. Masculine depression (vs. non-masculine depression and vs. no depression) was predicted by more frequent and critical use of alcohol (including binge drinking), tobacco, and illicit drugs, and by longer working times. Moreover, fewer health services contacts due to mental complaints during the previous year were associated with masculine (vs. non-masculine) depression. Alarmingly, even critical substance misuse was not significantly associated with more frequent health services contacts; however, the higher the depression severity, the more contacts the patients reported. Here, we provide evidence that patients with masculine depression are highly burdened and undertreated, which applies equally to female and male patients. This study identified promising targets to establish specialized care offers.

Peripheral Upregulation of Parkinson’s Disease-Associated Genes Encoding α-Synuclein, β-Glucocerebrosidase, and Ceramide Glucosyltransferase in Major Depression

“…Although this represents the sole contrasting sex-specific effect observed in our investigation, it is important to note that different biological mechanisms in males and females regarding depression have been documented [ 58 ] and warrant further exploration. Moreover, the concept of masculine depression, which refers to alternative depression symptoms more commonly associated with the male gender, such as externalizing behaviors, emotional suppression, substance misuse, and risk-seeking [ 59 , 60 , 61 ], deserves further attention.…”

TaKeTiNa Music Therapy for Outpatient Treatment of Depression: Study Protocol for a Randomized Clinical Trial

“…A trained rater (a physician or medical student assistant) conducts the HAMD-17 interview at the same time as the Montgomery-Åsberg Depression Rating Scale (MADRS) [41]. For further psychometric endpoints, we use the German versions of the Beck Depression Inventory II (BDI-II) [42] for self-evaluation, the Male Depression Rating Scale (MDRS-22) [43,44], and the Beck Anxiety Inventory (BAI) [45]. To additionally assess mindfulness, two scales are utilized: the Mindful Attention and Awareness Scale (MAAS) [46] and the German version of the Five Facet Mindfulness Questionnaire (FFMQ-D) [47,48].…”

“…For this reason, we plan to measure several metabolic markers that are associated with depression, such as serum lipids [27], hormones such as cortisol, and the level of cellular function, as well as the ratios of different immune cells and their production levels of cytokines and their ability to be stimulated in vitro. We will also assess the novel aspect of masculine depression (scale MDRS) characterized by specific traits and burdens with possibly different underlying mechanisms [43,67,68].…”