Sex differences in clinical predictors of depression: A prospective study

Abstract

Background Estimating the likelihood of future major depressive episodes (MDEs) would assist clinicians in decision-making regarding the optimal length of treatment for MDE. Unfortunately, little data are available to guide clinical practice. Methods We followed 200 females and 152 males who responded to treatment for a MDE for 2 years to determine risk factors for future MDE. Cox Proportional Hazard Regression modeled time to first relapse into MDE and mixed effect logistic regression modeled monthly depression status. Results Females were more likely than males to experience a MDE in any month of the study, and marginally more likely to experience a relapse. By 12 months, 60% of females had relapsed compared to 51% of males (median time to relapse 8 vs 13 months, respectively). Several factors predicted worse outcome for both men and women: reported childhood abuse, earlier age of onset of first MDE, Bipolar Disorder, unemployment, and more years of education. For females, but not males, suicidal ideation predicted MDE relapse and both suicidal ideation and prior suicide attempts were associated with more time in a MDE. Limitations The naturalistic treatment of participants, exclusion of individuals with current comorbid alcohol or substance use disorder, and a follow up period of two years are limitations. Conclusions Women are more vulnerable to relapse and spend more time depressed compared to men. Identification of general and sex-specific risk factors for future depression may provide clinicians with useful tools to estimate need for ongoing pharmacotherapy in MDE.

Alleviated negative rather than positive attentional bias in patients with depression in remission: an eye-tracking study

“…43 – 45 Compared with men, women also have longer depressive episodes and are also more prone to relapse. 46 These findings imply that the attentional bias of RD patients may exhibit a sex difference, which requires further investigation.…”

Prevalence of depressive symptoms and diagnosed depression among subjects with longstanding type 1 diabetes and no serious chronic complications, hospitalized due to inadequate metabolic control of diabetes

“…This observation has been widely described in literature. The explanation is complex and involves psychological, environmental and neuroendocrinological factors [20,21].…”

Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control

“…Prior evidence suggests that the risk of depression is more strongly associated with personality factors in women than in men (Goodwin and Gotlib, 2004; Kendler and Gardner, 2014; Oquendo et al, 2013) with adverse acute stressors, alone or in combination with psychobiological factors, having a greater impact on risk of depression in adolescent boys relative to girls (Uddin et al, 2011; Uddin et al, 2010) and in men relative to women (Kendler and Gardner, 2014). In this study, anxiety, poor sleep quality and greater daytime disturbance were significantly correlated with the increasing CORT/CRP ratio values in men.…”