Context
Gender differences in mental disorders, including more anxiety-mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The “gender roles” hypothesis suggests that these differences should narrow as the roles of women and men become more equal.
Objective
To study time-space (i.e., cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the WHO World Mental Health (WMH) Survey Initiative and determine if this variation is significantly related to time-space variation in female gender role traditionality (GRT) as measured by aggregate patterns of female education, employment, marital timing, and use of birth control.
Design/Setting and Participants
Face-to face household surveys of 72,933 community-dwelling adults in Africa, the Americas, Asia, Europe, the Middle East, and the Pacific.
Main Outcomes
The WHO Composite International Diagnostic Interview (CIDI) assessed lifetime prevalence and age-of-onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in Female:Male (F:M) odds-ratios (ORs) of these disorders across cohorts defined by age ranges 18–34, 35–49, 50–64, and 65+. Structural equation analysis examined predictive effects of variation in GRT on these ORs.
Results
Women had more anxiety-mood disorders than men and men more externalizing-substance disorders than women in all cohorts and countries. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder (MDD) and substance disorders. This narrowing was significantly related to temporal (MDD) and spatial (substance disorders) variation in GRT.
Conclusion
While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied, substantial inter-cohort narrowing of differences in major depression was found related to changes in the traditionality of female gender roles. Further research is needed to understand why this temporal narrowing was confined to major depression.