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Sex and depression in the National Comorbidity Survey, I: lifetime prevalence, chronicity and recurrence
Abstract
Basic epidemiologic prevalence data are presented on sex differences in DSM-III-R major depressive episodes (MDE). The data come from the National Comorbidity Survey (NCS), the first survey in the U.S. to administer a structured psychiatric interview to a nationally representative sample of the general population. Consistent with previous research, women are approximately 1.7 times as likely as men to report a lifetime history of MDE. Age of onset analysis shows that this sex difference begins in early adolescence and persists through the mid-50s. Women also have a much higher rate of 12-month depression than men. However, women with a history of depression do not differ from men with a history of depression in either the probability of being chronically depressed in the past year or in the probability of having an acute recurrence in the past year. This means that the higher prevalence of 12-month depression among women than men is largely due to women having a higher risk of first onset. The implications of these results for future research are discussed in a closing section of the paper.
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“It is primarily girls who account for the increase in adolescence,2,3 evidencing a 2:1 sex difference in depression that continues throughout the reproductive years.4”
From Subthreshold Symptoms of Depression in Preadolescent Girls Are Stable and Predictive of Depressive Disorders (2008) · cites this paper as [4]
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Chronic social instability stress in female rats: A potential animal model for female depression
Herzog, C., Czéh, B., Corbach‐Söhle, S., Wuttke, W., Schulte‐Herbrüggen, O., Hellweg, R., Flügge, G., & Fuchs, E. (2009) · Neuroscience · doi:10.1016/j.neuroscience.2009.01.059 · Cited by 142
A Reproductive Subtype of Depression
Payne, J. L., Palmer, J. T., & Joffe, H. (2009) · Harvard Review of Psychiatry · doi:10.1080/10673220902899706 · Cited by 153
“Three lines of evidence support the idea of a reproductive subtype of depression: (1) correlations between reproductive depressions at different stages of reproductive life, (2) genetic studies, and (3) evidence that the risk for depression is elevated for women during times of hormonal change and decreased during tim…”
BackgroundNatsuaki, M. N., Klimes-Dougan, B., Ge, X., Shirtcliff, E. A., Hastings, P. D., & Zahn-Waxler, C. (2009) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374410902976320 · Cited by 145
“Because females are more likely than males to develop depression and anxiety-related disorders and symptoms starting around the time of pubertal transition (Ge et al, 1994 ; Hankin et al, 1998 ; Kessler, McGonagle, Swartz, Blazer, & Nelson, 1993 ), it has been speculated that this sex difference in internalizing probl…”
BackgroundPsychosocial and psychological interventions for treating antenatal depression
Dennis, C., Ross, L. E., & Grigoriadis, S. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006309.pub2 · Cited by 152
Wunsch, H., Christiansen, C. F., Johansen, M. B., Olsen, M., Ali, N., Angus, D. C., & Sørensen, H. T. (2014) · JAMA · doi:10.1001/jama.2014.2137 · Cited by 143
Bangasser, D. A., Zhang, X., Garachh, V., Hanhauser, E., & Valentino, R. J. (2011) · Physiology & Behavior · doi:10.1016/j.physbeh.2011.02.037 · Cited by 152
Differences between Men and Women in Treatment and Outcome after Traumatic Brain Injury
Mikolić, A., Klaveren, D. V., Groeniger, J. O., Wiegers, E., Lingsma, H. F., Zeldovich, M., von Steinbüchel, N., Maas, A. I. R., van Lennep, J. E. R., Polinder, S., et al. (2020) · Journal of Neurotrauma · doi:10.1089/neu.2020.7228 · Cited by 158
The impact of resilience and subsequent stressful life events on MDD and GAD
Sheerin, C. M., Lind, M. J., Brown, E. A., Gardner, C. O., Kendler, K. S., & Amstadter, A. B. (2017) · Depression and Anxiety · doi:10.1002/da.22700 · Cited by 147
Frøkjær, V. G., Pinborg, A. B., Holst, K. K., Overgaard, A., Henningsson, S., Heede, M., Larsen, E. C., Jensen, P. S., Agn, M., Nielsen, A. P., et al. (2015) · Biological Psychiatry · doi:10.1016/j.biopsych.2015.04.015 · Cited by 141
“The lifetime risk for major depression appears twice as high in women relative to men (1), even though this might be confounded by diagnostic criteria that tend not to appreciate the male experience of depressive symptoms (2).”
Sambamoorthi, U., Walkup, J. T., Olfson, M., & Crystal, S. (2000) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2000.06219.x · Cited by 140
Giltay, E. J., Enter, D., Zitman, F. G., Penninx, B. W. J. H., PELT, J. V., Spinhoven, P., & Roelofs, K. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2011.11.014 · Cited by 149
“There are important sex differences in prevalence proportions of psychiatric disorders, with women having a more than double the risk of depressive disorder, generalized anxiety disorder, social phobia, and panic disorders with or without agoraphobia [1–6].”
Wang, Y.-Y., Jiang, N.-Z., Cheung, E. F. C., Sun, H.-W., & Chan, R. C. K. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.05.001 · Cited by 138
“1% (Kessler et al., 1993), and 15% of people with MDD ultimately died by suicide (BlairWest et al.”
BackgroundLack, C. W., Storch, E. A., Keeley, M. L., Geffken, G. R., Ricketts, E. J., Murphy, T. K., & Goodman, W. K. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-009-0013-9 · Cited by 140
“This finding may be indicative of higher rates of internalizing disorders in girls [15], which, as our data suggest, are strongly predictive of QoL.”
ResultOsborn, A. J., Mathias, J. L., & Fairweather‐Schmidt, A. K. (2014) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2014.07.007 · Cited by 140
Metadata
- Authors
- Kessler, R.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Kessler, R
- ORCID
- Kessler, R
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 1993-11
- Volume
- 29
- Issue
- 2-3
- Pages
- 85-96
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1992284534
- Cited by
- 2,207
- References
- 67
- Citations by year
- 2026: 31 · 2025: 50 · 2024: 47 · 2023: 58 · 2022: 84 · 2021: 71 · 2020: 73 · 2019: 78 · 2018: 78 · 2017: 124 · 2016: 81 · 2015: 98 · 2014: 119 · 2013: 105 · 2012: 101
- FWCI
- 21.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- State University of New York
- Johns Hopkins University
- York University
- University of Toronto
- National Institute of Mental Health (5RO1 MH46376, R01MH046376, MH 46376, 90135190)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- sex differences, major depressive episode, depression prevalence, chronic depression, depression recurrence, age of onset, National Comorbidity Survey, men and women
- MeSH terms
- Adolescent, Adult, Age Factors, Chronic Disease, Cross-Sectional Studies, Depressive Disorder, Female, Humans, Male, Middle Aged, Personality Assessment, Psychiatric Status Rating Scales, Recurrence, Sex Factors, United States, Cohort Studies, Comorbidity, Incidence
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