Sex differences in depression symptoms in treatment-seeking adults: confirmatory analyses from the Sequenced Treatment Alternatives to Relieve Depression study
Open accessAbstract
Background Although epidemiologic research consistently reports greater prevalence of major depressive disorder in women, small sample sizes in many studies do not allow for full elaboration of illness characteristics. This article examines sex differences in terms of illness attributes in a cohort of 2541 outpatients from across the United States who enrolled in the Sequenced Treatment Alternatives to Relieve Depression study.Methods Confirmatory analyses were performed in 2541 outpatients comparing men and women with regard to sociodemographic features, comorbid Axis I and Axis III conditions, and illness characteristics. Results were compared with those of our previous report on the initial population of the first 1500 individuals enrolled in Sequenced Treatment Alternatives to Relieve Depression study.Results In both samples, nearly two thirds of the sample (62.5%) were women. Women had greater symptom severity, but men had more episodes of major depression, despite no difference in the length of illness. No differences in age of onset emerged. As in the first cohort, women showed greater rates of an anxiety disorder, bulimia, and somatoform disorder, as well as more past suicide attempts, whereas men showed more alcohol and substance abuse. Women reported more appetite, weight, hypersomnia, interpersonal sensitivity, gastrointestinal and pain complaints, and less suicidal ideation. Irritability was equally common in men and women.Conclusion This large analysis confirmed most of the clinical features and comorbidities found to be more prevalent in the first cohort of women. In addition, this analysis corroborated previous research suggesting higher rates of atypical and anxious depression in women but refuted the notion of an "irritable depression" found in men. The report confirmed the 1.7:1 ratio for depression seen across sexes in the National Comorbidity Survey.
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A recent meta-analysis found that Black Americans more frequently use catastrophizing, hoping and praying, and passive coping than White Americans.
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- Authors
- Marcus, S. M., Kerber, K. B., Rush, A. J., Wisniewski, S. R., Nierenberg, A., Balasubramani, G. K., Ritz, L., Kornstein, S., Young, E. A., & Trivedi, M. H.
- Affiliations
- University of Michigan (US)
- The University of Texas Southwestern Medical Center (US)
- University of Pittsburgh (US)
- Harvard University (US)
- National Institutes of Health (US)
- Virginia Commonwealth University (US)
- ORCID
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2008-05
- Volume
- 49
- Issue
- 3
- Pages
- 238-246
- ISSN
- 0010-440X (ISSN-L)
- PMC
- PMC2759282
- OpenAlex
- W2059981066
- Cited by
- 266
- References
- 40
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 19 · 2023: 28 · 2022: 28 · 2021: 22 · 2020: 12 · 2019: 20 · 2018: 13 · 2017: 8 · 2016: 11 · 2015: 11 · 2014: 12 · 2013: 11 · 2012: 7
- FWCI
- 7.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health (n01mh90003-26-0-0)
- National Institute of Mental Health (N01‐MH‐90003, N01 MH090003)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- sex differences, major depressive disorder, depressive symptoms, comorbidities, anxiety disorders, bulimia nervosa, somatoform disorders, suicide attempts, substance abuse, alcohol abuse, atypical depression, anxious depression, symptom severity, age of onset, length of illness, suicidal ideation, irritability, outpatients
- MeSH terms
- Adult, Ambulatory Care, Appetite, Mental Disorders, Body Weight, Depression, Fatigue, Female, Gastrointestinal Diseases, Humans, Interpersonal Relations, Irritable Mood, Male, Severity of Illness Index, Sex Factors, Suicide, Attempted, United States, Cohort Studies, Logistic Models
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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