Cited by 2,207Mental Health Treatment and AccessTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Sex and depression in the National Comorbidity Survey, I: lifetime prevalence, chronicity and recurrence

Kessler, R·1993·Journal of Affective Disorders

DOI 10.1016/0165-0327(93)90026-g

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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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“, 2011)) and because the sex gap diminishes with age and chronicity of depression (Eaton et al., 2008; Kessler et al., 1993).”
Psychiatric Comorbidity in Patients Evaluated for Chronic Epilepsy: A Differential Role of the Right Hemisphere?
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“In the present study, 44p of all patients with a psychiatric disease had a diagnosis of depression and 36p were considered moderately or severely depressed. This percentage parallels previous observation in comparable patient populations. Similar to previous epidemiological studies, a preponderance of the female gende…”
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Fear of Criticism and Rejection Mediates an Association Between Childhood Emotional Abuse and Adult Onset of Major Depression
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Depressive symptoms in older adults with and without a history of incarceration: A matched pairs comparison
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Developing zebrafish models relevant to PTSD and other trauma- and stressor-related disorders
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Ovarian hormones influence corticotropin releasing factor receptor colocalization with delta opioid receptors in CA1 pyramidal cell dendrites
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“…increased presence of the CRF receptor on the neuronal surface for response to CRF is consistent with compelling evidence of sexual dimorphism in stress reactivity and the increased prevalence of stress-related psychiatric disorders in women (Kessler et al., 1993, 1995; Marcus et al., 2005, 2008).”
The Social Reality of Depression: DTC Advertising of Antidepressants and Perceptions of the Prevalence and Lifetime Risk of Depression
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“At the population level it is clear that women experience greater disability burden from mental disorders because of their higher prevalence of depression and anxiety disorders (Kessler et al., 1993; Seedat et al., 2009).”
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“However, while women have been found to develop anxiety disorders, including specific and social phobias, at higher rates than men (Bruce et al., 2005; Eaton et al., 2012; Kessler et al., 1993), prior research has found gender-related differences to be least pronounced for social anxiety disorder (Breslau et al.”
Background
Environmental manipulation affects depressive-like behaviours in female Wistar-Kyoto rats
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Unipolar depression in the Belgian population
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“Some authors [3, 24 ] argue that the gender gap will not close in the light of changing adult sex roles because women, despite the fact that they have a greater risk of becoming depressed, once they have been diagnosed as such, are more vulnerable to stressful events.”
BackgroundInfluential
Rumination and Interpersonal Dependency: Explaining Women's Vulnerability to Depression
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Two repeated maternal separation procedures differentially affect brain 5-hydroxytryptamine transporter and receptors in young and adult male and female rats
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Predicting Smoking Status in a College‐Age Population
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Menopausal transition and depression: who is at risk and how to treat it?
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The relationship between inflammatory state and quantity of affective episodes in bipolar disorder
Queissner, R., Pilz, R., Dalkner, N., Birner, A., Bengesser, S. A., Platzer, M., Fellendorf, F. T., Kainzbauer, N., Herzog-Eberhard, S., Hamm, C., et al. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.01.024 · Cited by 35
Relationship of Age, Age at Onset, and Sex to Depression in Older Adults
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High rate of suicide attempt and associated psychological traits in an isolated tribal population of North-East India
Singh, P. K., Singh, R. K., Biswas, A., & Rao, V. R. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.07.018 · Cited by 35
“As found in previous studies from all parts of the world, depression is an important risk factor, particularly for females (Weissman, 1971; Kessler et al., 1993; Ponnudurai et al., 1991).”
Result
Maternal Care Received by Individual Pups Correlates with Adult CA1 Dendritic Morphology and Synaptic Plasticity in a Sex‐Dependent Manner
van Hasselt, F. N., Boudewijns, Z. S. R. M., van der Knaap, N. J. F., Krugers, H. J., & Joëls, M. (2011) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2011.02233.x · Cited by 35
Advances in multidisciplinary and cross-species approaches to examine the neurobiology of psychiatric disorders
Kas, M. J., Krishnan, V., Gould, T. D., Collier, D. A., Olivier, B., Lesch, K., Domenici, E., Fuchs, E., Gross, C. T., & Ċastrén, E. (2011) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2010.12.001 · Cited by 36
“MDD ranks among the top causes of worldwide disease burden and disability, with a lifetime risk of 7% to 12% in men and 20% to 25% in women (Kessler et al., 1993, 2005b).”
Background
Attentional bias training in girls at risk for depression
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Alcohol use and bipolar disorders: Risk factors associated with their co-occurrence and sequence of onsets
Azorin, J., Perret, L. C., Fakra, É., Tassy, S., Simon, N., Adida, M., & Belzeaux-R, R. (2017) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2017.07.005 · Cited by 35
“The higher prevalence rates of AUD in males are similar to the vast majority of data from the general population (Regier et al., 1990; Kessler et al., 1993; Angst et al., 2010) and among bipolar patients (Hendrick et al.”
BackgroundResult
Psychological Morbidity in the Farming Community: A Literature Review
Chiswell, H. M. (2022) · Journal of Agromedicine · doi:10.1080/1059924x.2022.2089419 · Cited by 40
“7% (12-month rate) amongst males in the general population.(87) Although a comparatively higher prevalence was observed amongst farming women (9.”
Background
Neonatal exposure to fluoxetine and fluvoxamine alteres spine density in mouse hippocampal CA1 pyramidal neurons.
Zheng, J., Xu, D., Li, K., Wang, H., Shen, P.-C., Lin, M., Cao, X.-H., & Wang, R. (2011) · PubMed Central · Cited by 35
Women's mental health: A silent cause of mortality and morbidity
Stewart, D. E., Ashraf, I. J., & Munce, S. (2006) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2006.04.025 · Cited by 35
Gender similarities still rule.
Hyde, J. S. (2006) · American Psychologist · doi:10.1037/0003-066x.61.6.641b · Cited by 37
Gender Differences in Bipolar Disorder Type 1
Benedetti, A., Fagiolini, A. M., Casamassima, F., Mian, M. S., Adamovit, A., Musetti, L., Lattanzi, L., & Cassano, G. B. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000243781.67035.b1 · Cited by 35
“This is in agreement with the findings of some (Judd and Akiskal, 2003; Kawa et al., 2005, Raymont et al., 2003), but not all of the previous studies on this topic (Goodwin and Jamison, 1990; Kessler et al., 1993; Robb et al., 1998; Taylor and Abrams, 1981).”
Result

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)
DOI: 10.1016/0165-0327(93)90026-g
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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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Sex and depression in the National Comorbidity Survey, I: lifetime prevalence, chronicity and recurrence

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