Gender differences in chronic major and double depression

Kornstein, S.G; Schatzberg, A.F; Thase, M.E; Yonkers, K.A; McCullough, J.P; Keitner, G.I; Gelenberg, A.J; Ryan, C.E; Hess, A.L; Harrison, W; Davis, S.M; Keller, M.B

Next »Journal of Affective Disorders
Volume 60, Issue 1 , Pages 1-11, October 2000

Gender differences in chronic major and double depression

S.G Kornstein
- Medical College of Virginia, Virginia Commonwealth University, Richmond, VA, USA
- Corresponding author. Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, P.O. Box 980710, Richmond, VA 23298-0710, USA. Tel.: +1-804-8289-452; fax: +1-804-8285-058
A.F Schatzberg
- Stanford University School of Medicine, Stanford, CA, USA
M.E Thase
- University of Pittsburgh and Western Psychiatric Institute, Pittsburgh, PA, USA
K.A Yonkers
- University of Texas Southwestern Medical Center, Dallas, TX, USA
J.P McCullough
- Virginia Commonwealth University, Richmond, VA, USA
G.I Keitner
- Brown University, Providence, RI, USA
A.J Gelenberg
- University of Arizona, Tucson, AZ, USA
C.E Ryan
- Brown University, Providence, RI, USA
A.L Hess
- Virginia Commonwealth University, Richmond, VA, USA
W Harrison
- Pfizer, Inc. and College of Physicians and Surgeons, Columbia University School of Medicine, New York, NY, USA
S.M Davis
- Quintiles, Inc., Research Triangle Park, NC, USA
M.B Keller
- Brown University, Providence, RI, USA

Received 8 April 1998; accepted 8 September 1999.

Abstract

Background: While the sex difference in prevalence rates of unipolar depression is well established, few studies have examined gender differences in clinical features of depression. Even less is known about gender differences in chronic forms of depression. Methods: 235 male and 400 female outpatients with DSM-III-R chronic major depression or double depression (i.e., major depression superimposed on dysthymia) were administered an extensive battery of clinician-rated and self-report measures. Results: Women were less likely to be married and had a younger age at onset and greater family history of affective disorder compared to men. Symptom profile was similar in men and women, with the exception of more sleep changes, psychomotor retardation and anxiety/somatization in women. Women reported greater severity of illness and were more likely to have received previous treatment for depression with medications and/or psychotherapy. Greater functional impairment was noted by women in the area of marital adjustment, while men showed more work impairment. Limitations: Since our population consisted of patients enrolling in a clinical trial, study exclusion criteria may have affected gender-related differences found. Conclusions: Chronicity of depression appears to affect women more seriously than men, as manifested by an earlier age of onset, greater family history of affective disorders, greater symptom reporting, poorer social adjustment and poorer quality of life. These findings represent the largest study to date of gender differences in a population with chronic depressive conditions.

Keywords: Chronic depression, Gender differences, Age of onset, Symptoms, Family history, Functional impairment