A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males
Summary & key facts
The paper presents a hypothesis that gender differences in how people report depression may explain why more women are diagnosed with depression while men have higher suicide and addictive behavior rates. The authors suggest women may report mild-to-moderate symptoms more often, and men may be more likely to present with severe depression, suicide, or different (atypical) symptoms. They point to three possible reasons: links with estrogen and timing of female depression, men's tendency to hide feelings and avoid help, and different symptom patterns in men. The paper says this could mean depression in men is often missed and calls for more research and changes in diagnosis and awareness.
- The authors propose a hypothesis that mild-to-moderate depression is reported more often by females, while severe depression and suicide are reported more often by males.
- They suggest three possible mechanisms: (1) a link between estrogen levels and peaks in female depression, (2) gender differences in coping style such as emotional inexpressiveness and less help-seeking in males, and (3) gender differences
- The paper argues the current pattern of reporting could lead to under-diagnosis and under-treatment of depression in males.
- The authors recommend considering male-pattern depressive symptoms in diagnostic criteria, encouraging men to express negative emotions, and increasing awareness of suicidal behavior in males.
- The article is a hypothesis paper, not definitive proof; the authors call for further research to test these ideas.
Abstract
The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.
