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Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness
Open accessAbstract
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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“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]
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“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]
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“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]
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“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]
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“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
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“there is a clear sex difference in the prevalence of PTSD and other fear-and anxiety-based disorders (Kessler et al, 1995;McLean et al, 2011)”
From Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond (2017) · cites this paper as McLean et al, 2011
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“Women generally have higher prevalence rates for most anxiety disorders, compared with men [4,5,9].”
From Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders (2014) · cites this paper as [9]
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“With respect to femininity, the results showed contradictory information. While there are studies that have not found a relationship between femininity and anxiety, 64 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]
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“some of the most salient risk factors for women observed from our review were rumination33,44,49,65,73 and anxiety sensitivity.51,55,57,65”
From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [49]
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“(b) the fluctuations of sexual hormones that affect the anxious state of women,46,49,63,64,66,69”
From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [49]
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“Similar trends were reported during previous pandemics [61,62,63,64].”
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]
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“These intriguing findings corroborate the assumption of enhanced sensitivity to cognitive effects of IN in women and indicate a potential new role of IN insulin as a pharmacological adjuvant in cognitive-behavioural therapy of anxiety disorders, which, notably, have a higher prevalence in women.155”
From Intranasal insulin (2021) · cites this paper as [155]
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Citations
Cites
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“This is consistent with previous work demonstrating that anxiety disorders are associated with disproportionately high rates of medical health care service use (Wang et al., 2005).”
MethodResultTrauma and Posttraumatic Stress Disorder in the Community: The 1996 Detroit Area Survey of Trauma
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Metadata
- 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.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 45
- Issue
- 8
- Pages
- 1027-1035
- ISSN
- 0022-3956 (ISSN-L)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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