Masculine depression and its problem behaviors: use alcohol and drugs, work hard, and avoid psychiatry!
Summary & key facts
This case-control study looked at 163 depressed in-patients (44% women) and 176 controls (51% women). Researchers divided depressed patients into ‘masculine’ versus ‘non-masculine’ depression using a median split on the Male Depression Rating Scale-22. They found that people with masculine depression had worse depressive symptoms, used alcohol (including binge drinking), tobacco, and illicit drugs more often, worked longer hours, and had fewer contacts with mental health services in the prior year. These patterns were seen in both men and women. The authors say evidence on this topic is still limited and these results point to groups that may be highly burdened and undertreated.
- The study sample was 163 depressed in-patients (44% women) and 176 control participants (51% women).
- Depressed patients were split into ‘masculine’ and ‘non-masculine’ groups using a median split of the Male Depression Rating Scale-22.
- Patients labeled as having masculine depression showed higher depression severity than those with non-masculine depression.
- Masculine depression (compared with non-masculine depression and with no depression) was associated with more frequent and critical use of alcohol (including binge drinking), tobacco, and illicit drugs.
- Longer working hours predicted masculine depression compared with non-masculine depression and no depression.
- Patients with masculine depression reported fewer health-service contacts for mental complaints in the previous year than those with non-masculine depression.
- Even when substance misuse was critical, it was not significantly linked to more frequent health-service contacts; by contrast, higher depression severity was linked to more health-service contacts.
- The authors note that empirical evidence about male-pattern or ‘masculine’ depression is still limited, and they used the term to include female patients as well.
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.
