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Depression in Women

Published online by Cambridge University Press:  06 August 2018

E. S. Paykel
E. S. Paykel*
Affiliation:
University of Cambridge Department of Psychiatry, Addenbrooke's Hospital, Cambridge CB2 2QQ
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Abstract

Depression in treated samples shows an approximately 2:1 female predominance. The sex ratio is not due simply to more help-seeking behaviour in women, for it applies equally in studies of community prevalence. Differential acknowledgement and direction of distress may be a partial explanation, supported by male predominance of alcoholism and completed suicide, and by a possible recent increase in depression in young men. Biological mechanisms acting through hormonal effects on the brain are plausible, but hard to test. Epidemiological studies indicate that much of the excess occurs in married women aged 25–45 years with children. This strongly suggests social causation and highlights the vulnerable situation of young mothers. The full explanations for the sex difference are not yet clear, but are likely to combine factors related to expression of distress, biology and social situation.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue S10: Women and Mental Health , May 1991 , pp. 22 - 29
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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References

Adelstein, A. M., Downham, D. Y., Stein, Z., et al (1964) The epidemiology of mental illness in an English city: inceptions recognised by Salford Psychiatric Services. Social Psychiatry, 3, 445–468.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual for Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Angst, J. & Dobler-Mikola, A. (1984) The definition of depression. Journal of Psychiatric Research, 18, 401–406.Google Scholar
Bebbington, P. E. (1987) Marital status and depression: a study of English national admission statistics. Acta Psychiatrica Scandinavica, 75, 640–650.Google Scholar
Bebbington, P. E., Hurry, J., Tennant, C., et al (1981) Epidemiology of mental disorders in Camberwell. Psychological Medicine, 11, 561–579.Google Scholar
Bebbington, P. E., Dean, C., Der, G., et al (1991) Gender, parity and the prevalence of minor affective disorder. British Journal of Psychiatry, 158, 40–45.Google Scholar
Blumenthal, M. D. (1975) Measuring depressive symptomatology in a general population. Archives of General Psychiatry, 32, 971–978.Google Scholar
Boyd, J. H. & Weissman, M. M. (1982) Epidemiology. In Handbook of Affective Disorders, (ed. E. S. Paykel) Edinburgh: Churchill Livingstone.Google Scholar
Briscoe, M. (1982) Sex differences in psychological well-being. In Psychological Medicine (monograph suppl. 1). Cambridge: Cambridge University Press.Google Scholar
Brockington, I. F., Martin, C., Brown, G. W., et al (1990) Stress and puerperal psychosis. British Journal of Psychiatry, 157, 319–326.CrossRefGoogle ScholarPubMed
Brown, G. W. & Harris, T. O. (1978) Social Origins of Depression. A Study of Psychiatric Disorder in Women. London: Tavistock.Google Scholar
Brown, G. W. & Prudo, R. (1981) Psychiatric disorder in a rural and an urban population: 1. Aetiology of depression. Psychological Medicine, 11, 581–599.Google Scholar
Brown, G. W., Andrews, B., Harris, T., et al (1986) Social support, self-esteem and depression. Psychological Medicine, 16, 813–831.Google Scholar
Canino, G. J., Bird, H. R., Shrout, P. E., et al (1987) The prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry, 44, 727–735.Google Scholar
Cannon, M. & Redick, R. (1973) Differential Utilisation of Psychiatric Facilities by Men and Women: US 1970. Statistical note 81, June 1973. Washington DC: Surveys and Reports Section, US Department of Health, Education and Welfare.Google Scholar
Comstock, G. W. & Helsing, K. J. (1976) Symptoms of depression in two communities. Psychological Medicine, 6, 551–563.Google Scholar
Cooper, M., Lemkau, P. & Tietze, C. (1942) Complaint of nervousness and the psychoneuroses: an epidemiological viewpoint. American Journal of Orthopsychiatry, 12, 214–223.Google Scholar
Cooper, P. J. & Stein, A. (1989) Life events and postnatal depression: the Oxford study. In Current Approaches: Childbirth as a Life Event (eds Cox, J. L., Paykel, E. S. & Page, M. L.). Southampton: Duphar Medical Relations.Google Scholar
Cox, J. L., Paykel, E. S. & Page, M. L. (eds) (1989) Current Approaches: Childbirth as a Life Event. Southampton: Duphar Medical Relations.Google Scholar
Dean, C., Surtees, P. G. & Sashidharan, S. P. (1983) Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry, 142, 247–256.Google Scholar
Dowlatshahi, D. & Paykel, E. S. (1990) Life events and social stress in puerperal psychoses: absence of effect. Psychological Medicine, 20, 655–662.Google Scholar
Duval, H. J., Kramer, M. & Locke, B. Z. (1966) Psychoneuroses among first admissions to psychiatric facilities in Ohio, 1958–1961. Community Mental Health Journal, 2, 237–243.CrossRefGoogle Scholar
Egeland, J. A. & Hostetter, A. M. (1983) Amish study. I: Affective disorders among the Amish, 1976–1980. American Journal of Psychiatry, 140, 56–61.Google Scholar
Essen-Moller, E. & Hagnell, O. (1961) The frequency and risk of depression within a rural population in Scandinavia. Acta Psychiatrica Scandinavica, 162, (suppl.), 28–32.Google Scholar
Gardner, E. A., Bahn, A. K., Miles, H. C., et al (1963) All psychiatric experience in a community. Archives of General Psychiatry, 9, 365–378.Google Scholar
Gater, R. A., Dean, C. & Morris, J. (1989) The contribution of childbearing to the sex difference in first admission rates for affective psychosis. Psychological Medicine, 19, 719–724.Google Scholar
Gove, W. R. & Tudor, J. R. (1973) Adult sex roles and mental illness. American Journal of Sociology, 78, 812–835.Google Scholar
Grad De Alarcon, J., Sainsbury, P. & Costain, W. R. (1975) Incidence of referred mental illness in Chichester and Salisbury. Psychological Medicine, 5, 32–54.Google Scholar
Grewel, F. (1967) Psychiatric differences in Ashkenazim and Sephardim. Psychiatry, Neurology and Neurochir, 70, 339–347.Google Scholar
Hallstrom, T. (1973) Mental Disorder and Sexuality in the Climacteric. Goteberg, Sweden: Ortadius Biktryckeri AB.Google Scholar
Henderson, S., Duncan-Jones, P., Byrne, D. G., et al (1979) Psychiatric disorder in Canberra. A standardised study of prevalence. Acta Psychiatrica Scandinavica, 60, 355–374.Google Scholar
Hinckle, L. E., Redmont, R., Plummer, N., et al (1960) II. An explanation of the relation between symptoms, disability, and serious illness in two homogeneous groups of men and women. Journal of Public Health, 50, 1327–1336.Google Scholar
Jenkins, R. (1985) Sex differences in minor psychiatric morbidity. In Psychological Medicine (monograph suppl. 7). Cambridge: Cambridge University Press.Google Scholar
Jorm, A. F. (1987) Sex and age differences in depression: a quantitative synthesis of published research. Australian and New Zealand Journal of Psychiatry, 21, 46–53.Google Scholar
Joyce, P. R., Oakley-Browne, M. A., Wells, J. E., et al (1990) Birth cohort trends in major depression: increasing rates and earlier onset in New Zealand. Journal of Affective Disorders, 18, 83–89.Google Scholar
Juel-Nielsen, N., Bille, M., Flygenring, J., et al (1961) Frequency of depressive states within geographically delimited population groups. Acta Psychiatrica Scandinavica, 162, 69–80.Google Scholar
Kendell, R. E., Chalmers, J. C. & Platz, C. (1987) Epidemiology of puerperal psychoses. British Journal of Psychiatry, 150, 662–673.Google Scholar
Kessler, R. C., Brown, R. L. & Broman, C. L. (1981) Sex differences in psychiatric help-seeking: evidence from four large-scale surveys. Journal of Health and Social Behavior, 22, 49–64.Google Scholar
Kielholz, P. (1959) Drug treatment of depressive states. Canadian Psychiatric Association Journal, 4S, 129–137.Google Scholar
Klerman, G. L. (1988) The current age of youthful melancholia. Evidence for increase in depression among adolescents and young adults. British Journal of Psychiatry, 152, 4–14.Google Scholar
Lehmann, H. E. (1971) The epidemiology of depressive disorders. In Depression in the 70s (ed. R. R. Fieve). The Hague: Excerpta Medica.Google Scholar
Martin, C. J., Brown, G. W., Goldberg, D. P., et al (1989) Psychosocial stress and puerperal depression. Journal of Affective Disorders, 16, 283–293.Google Scholar
Martin, F. M., Brotherston, J. H. F. & Chave, S. P. W. (1957) Incidence of neurosis in a new housing estate. British Journal of Preventive and Social Medicine, 11, 196–148.Google Scholar
Mavreas, V. G., Beis, A., Mouyias, A., et al (1978) Psychiatric disorders in Athens. A community study. Social Psychiatry, 21, 172–181.Google Scholar
McGuffin, P. & Katz, R. (1986) Nature, nurture and affective disorder. In The Biology of Depression (ed. J. F. W. Deakin). London: Royal College of Psychiatrists/Gaskell.Google Scholar
McKinley, S. M. & Jeffries, M. (1974) The menopausal syndrome. British Journal of Preventive and Social Medicine, 28, 108–115.Google Scholar
Mellinger, G. D., Balter, M. B., Parry, H. J., et al (1974) An overview of psychotherapeutic drug use in the United States. In Drug Use: Epidemiological and Sociological Approaches, (eds Josephson, E. & Carrol, E. E.), pp. 333–336. New York: Hemisphere Publishing.Google Scholar
Mendelwicz, J., Simon, P., Sevy, S., et al (1987) Polymorphic DNA markers on X chromosome and manic-depression. Lancet, i, 1230–1231.Google Scholar
Murphy, J. M. (1986) Trends in depression and anxiety: men and women. Acta Psychiatrica Scandinavica, 73, 113–127.Google Scholar
Myers, J. K., Weissman, M. M., Tischler, G. L., et al (1984) Six-month prevalence of psychiatric disorders in three communities: 1980–1982. Archives of General Psychiatry, 41, 959–967.Google Scholar
Odegaard, O. (1961) The epidemiology of depressive psychoses. Acta Psychiatrica Scandinavica, 162, 33–38.Google Scholar
Parker, G. (1987) Are lifetime prevalence estimates in the ECA study accurate? Psychological Medicine, 17, 275–282.Google Scholar
Parry, G. (1986) Paid employment, life events, social support and mental health in working class mothers. Journal of Health and Social Behaviour, 27, 193–208.Google Scholar
Paykel, E. S. (1974) Recent life events and clinical depression. In Life Stress and Illness (eds Gunderson, E. K. E. & Rahe, R. H.). Springfield, Illinois: Charles C. Thomas.Google Scholar
Paykel, E. S. & Cooper, Z. (1991) Life events and social stress. In Handbook of Affective Disorders (2nd edn) (ed. E. S. Paykel). Edinburgh: Churchill Livingstone (in press).Google Scholar
Paykel, E. S., Emms, E. M., Fletcher, J., et al (1980) Life events and social support in puerperal depression. British Journal of Psychiatry, 136, 339–346.Google Scholar
Paykel, E. S., Klerman, G. L. & Prusoff, B. A. (1970) Treatment setting and clinical depression. Archives of General Psychiatry, 22, 11–21.Google Scholar
Paykel, E. S., Prusoff, B. A. & Uhlenhuth, E. H. (1971) Scaling of life events. Archives of General Psychiatry, 25, 340–347.Google Scholar
Pedersen, A. M., Barry, D. J. & Babigian, H. M. (1972) Epidemiological considerations of psychotic depression. Archives of General Psychiatry, 27, 193–197.Google Scholar
Romans-Clarkson, S. E., Walton, V. A., Herbison, G. P., et al (1988) Marriage, motherhood and psychiatric morbidity in New Zealand. Psychological Medicine, 18, 983–990.Google Scholar
Rosen, B. F., Bahn, A. K. & Kramer, M. (1964) Demographic and diagnostic characteristics of psychiatric clinic outpatients in the USA, 1961. American Journal of Orthopsychiatry, 34, 445–468.Google Scholar
Shapiro, S., Skinner, E. A., Kessler, L. G., et al (1984) Utilization of health and mental health services. Three epidemiologic catchment area sites. Archives of General Psychiatry, 41, 971–978.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Tarnower, S. M. & Humphries, M. (1969) Depression: a recurring, genetic illness more common in females. Diseases of the Nervous System, 30, 601–604.Google Scholar
Uhlenhuth, E. H. & Paykel, E. S. (1973) Symptom intensity and life events. Archives of General Psychiatry, 28, 473–477.Google Scholar
Warheit, G. J., Holzer III, C. E. & Schwab, J. J. (1973) An analysis of social class and racial differences in depressive symptomatology: a community study. Journal of Health and Social Behaviour, 14, 291–299.Google Scholar
Watson, J. P., Elliott, S. A., Rugg, A. J., et al (1984) Psychiatric disorder in pregnancy and the first postnatal year. British Journal of Psychiatry, 144, 453–462.Google Scholar
Wechsler, H. (1961) Community growth, depressive disorders, and suicide. American Journal of Sociology, 67, 9–16.Google Scholar
Weissman, M. M. & Klerman, G. L. (1977) Sex differences and the epidemiology of depression. Archives of General Psychiatry, 34, 98–111.Google Scholar
Weissman, M. M. & Myers, J. K. (1978a) Rates and risks of depressive symptoms in a United States urban community. Acta Psychiatrica Scandinavica, 57, 219–231.Google Scholar
Weissman, M. M. & Myers, J. K. (1978b) Affective disorders in a US urban community. The use of Research Diagnostic Criteria in an epidemiological survey. Archives of General Psychiatry, 35, 1304–1311.Google Scholar
Weissman, M. M. & Slaby, A. E. (1973) Oral contraceptives and psychiatric disturbance: evidence from research. British Journal of Psychiatry, 123, 513–518.Google Scholar
Wilhelm, K. & Parker, G. (1989) Is sex necessarily a risk factor to depression? Psychological Medicine, 19, 401–413.Google Scholar
Wing, J. K. & Sturt, E. (1978) The PSE – ID – CATEGO System: Supplementary Manual. London: MRC Social Psychiatry Unit.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms: an Instruction Manual for the PSE and Catego Program. London: Cambridge University Press.Google Scholar
Winokur, G. (1973) Depression in the menopause. American Journal of Psychiatry, 130, 92–93.Google Scholar
Winokur, G. (1979) Unipolar depression. Is it divisible into autonomous subtypes? Archives of General Psychiatry, 36, 47–52.Google Scholar
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