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Cited by 2,519Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and AccessChild and Adolescent Psychosocial and Emotional Development

Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness

Open access
McLean, Carmen P., Asnaani, Anu, Litz, Brett T., Hofmann, Stefan G.·2011·Journal of Psychiatric Research
DOI 10.1016/j.jpsychires.2011.03.006PMC PMC3135672
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Abstract

Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N=20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence. No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extend also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men.

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Crossref · 10.1016/j.jpsychires.2011.03.006

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  • Mclean et al. 2011 reported that anxiety and stress disorders have a higher prevalence in women, which can explain discrepancies in prescriptions for men vs women.

    “Mclean et al. 2011 reported that the diagnosis of anxiety and stress disorders has a higher prevalence in women, which can explain the discrepancies in the prescription for men vs. women [30].”

    From Benzodiazepines: Uses, Dangers, and Clinical Considerations (2021) · cites this paper as [30]

    The Discussion reports that anxiety disorders were approximately 1.5 to 2 times as common among women as men. It does not establish that this difference explains prescription discrepancies; the Discussion explicitly says the study did not examine the type of treatment sought. Page numbers were not supplied in the passages. (LLM, conf=0.88)

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  • Femininity accompanied by low self-esteem favored the development of anxiety.

    “other studies revealed that femininity accompanied by low self-esteem favored the development of anxiety.49,70”

    From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [49]

    The Discussion links gender-related factors to anxiety and describes anxiety as more consistent with a feminine than a traditional masculine gender role. It does not identify low self-esteem as part of that association or establish that femininity combined with low self-esteem favors the development of anxiety; the Discussion also says the study’s cross-sectional design precludes causal analysis. (LLM, conf=0.78)

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  • Women in the general population are more likely than men to report mental disorders.

    “The results align with evidence that women in the general population are more likely than men to report mental disorders,57–59”

    From Mental Disorder Symptoms among Public Safety Personnel in Canada (2018) · cites this paper as [57]

    The Abstract and Discussion (page numbers not provided) report that women in a large U.S. population sample had higher rates of anxiety disorders than men. This supports the claim for anxiety disorders, but the paper does not establish that women are more likely to report mental disorders generally. (LLM, conf=0.86)

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  • Female gender was noted to have higher levels of depression, anxiety and stress compared to male gender.

    “the female gender was noted to have higher levels of depression, anxiety and stress as compared to the male gender.”

    From Relationships between psychopathology, psychological process variables, and sociodemographic variables and comparison of quarantined and non-quarantined groups of malaysian university students in the covid-19 pandemic (2021) · cites this paper as [64]

    The Discussion (page not provided) reports that anxiety disorders were more common among women and that women with an anxiety disorder were more likely than men to have comorbid major depressive disorder. The study compares diagnoses and prevalence, not general levels of depression, anxiety, and stress; it does not report a gender comparison of stress levels. (LLM, conf=0.88)

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  • The imbalance in gender distribution favoring women is consistent with treatment seeking patterns for all anxiety disorders including GAD.

    “However, this imbalance in gender distribution favoring women is consistent with treatment seeking patterns for all anxiety disorders including GAD (e.g., McLean et al., 2011).”

    From Distinct functional connectivities predict clinical response with emotion regulation therapy (2017) · cites this paper as McLean et al., 2011

    The Discussion reports that anxiety disorders, particularly GAD, were more prevalent among women. The Results (Burden of Illness; page unavailable) also report more general medical visits among women with anxiety than men with anxiety, but equal rates of visits to a professional for emotional or substance-use issues. The paper does not establish a female-favoring treatment-seeking pattern for every anxiety disorder, including GAD. (LLM, conf=0.86)

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Authors
McLean, C. P., Asnaani, A., Litz, B. T., & Hofmann, S. G.
Affiliations
  • VA Boston Healthcare System (US)
  • Boston University (US)
Corresponding author
McLean, Carmen P.
ORCID
Venue
Journal of Psychiatric Research
Publisher
Elsevier BV
Published
2011-08
Volume
45
Issue
8
Pages
1027-1035
ISSN
0022-3956 (ISSN-L)
DOI
10.1016/j.jpsychires.2011.03.006
PMC
PMC3135672
OpenAlex
W2051719689
Cited by
2,519
References
89
Citations by year
2026: 225 · 2025: 253 · 2024: 253 · 2023: 225 · 2022: 275 · 2021: 293 · 2020: 241 · 2019: 158 · 2018: 153 · 2017: 139 · 2016: 91 · 2015: 80 · 2014: 56 · 2013: 40 · 2012: 26
FWCI
53.13
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Psychiatric Research (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R01MH078308)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
gender differences, anxiety disorders, prevalence, clinical course, comorbidities, disease burden, age of onset, chronicity, social anxiety disorder, bulimia nervosa, major depressive disorder, European American women, Hispanic women
MeSH terms
Adult, Anxiety Disorders, Asian, Major Depressive Disorder, Female, Health Surveys, Hispanic or Latino, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Sex Characteristics, United States, Comorbidity, Prevalence, Logistic Models, Cost of Illness, Age of Onset, Substance-Related Disorders, White People, Bulimia Nervosa

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