Sex differences in anxiety and depression: circuits and mechanisms
Abstract
Epidemiological sex differences in anxiety disorders and major depression are well characterized. Yet the circuits and mechanisms that contribute to these differences are understudied, because preclinical studies have historically excluded female rodents. This oversight is beginning to be addressed, and recent studies that include male and female rodents are identifying sex differences in neurobiological processes that underlie features of these disorders, including conflict anxiety, fear processing, arousal, social avoidance, learned helplessness and anhedonia. These findings allow us to conceptualize various types of sex differences in the brain, which in turn have broader implications for considering sex as a biological variable. Importantly, comparing the sexes could aid in the discovery of novel therapeutics.
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Many biological studies are centralized on animal studies, which precludes analysis of gender and other psychosocial factors.
“Many of them are even centralized on animal studies, 22 which precludes the analysis of gender and other psychosocial factors.”
From Factors associated with gender and sex differences in anxiety prevalence and comorbidity: A systematic review (2022) · cites this paper as [22]
Sex differences in stress responses are thought to contribute to sex differences in anxiety risk.
“Sex differences in stress responses are thought to contribute to sex differences in the anxiety risk (3–5), as anxiety rates are higher in women vs. men (6–11).”
From Sexual differentiation of neural mechanisms of stress sensitivity during puberty (2023) · cites this paper as [3]
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. (2012) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1359 · Cited by 2,947 · see citing works
Explaining the gender difference in depressive symptoms.
Nolen-Hoeksema, S., Larson, J., & Grayson, C. (1999) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.77.5.1061 · Cited by 1,543 · see citing works
Sex differences in anxiety and depression clinical perspectives
Altemus, M., Sarvaiya, N., & Neill Epperson, C. (2014) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2014.05.004 · Cited by 1,413 · see citing works
Learned helplessness at fifty: Insights from neuroscience.
Maier, S. F., & Seligman, M. E. P. (2016) · Psychological Review · doi:10.1037/rev0000033 · Cited by 919 · see citing works
The Social Salience Hypothesis of Oxytocin
Shamay-Tsoory, S. G., & Abu-Akel, A. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2015.07.020 · Cited by 904 · see citing works
Sex-specific transcriptional signatures in human depression
Labonté, B., Engmann, O., Purushothaman, I., Menard, C., Wang, J., Tan, C., Scarpa, J. R., Moy, G., Loh, Y.-H. E., Cahill, M., et al. (2017) · Nature Medicine · doi:10.1038/nm.4386 · Cited by 748 · see citing works
Sex Differences in Animal Models: Focus on Addiction
Becker, J. B., & Koob, G. F. (2016) · Pharmacological Reviews · doi:10.1124/pr.115.011163 · Cited by 725 · see citing works
Elevated CSF corticotropin-releasing factor concentrations in posttraumatic stress disorder
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.5.624 · Cited by 721 · see citing works
Work stress precipitates depression and anxiety in young, working women and men
MELCHIOR, M., CASPI, A., MILNE, B. J., DANESE, A., POULTON, R., & MOFFITT, T. E. (2007) · Psychological Medicine · doi:10.1017/s0033291707000414 · Cited by 691 · see citing works
De novo conditioning in trauma-exposed individuals with and without posttraumatic stress disorder.
Orr, S. P., Metzger, L. J., Lasko, N. B., Macklin, M. L., Peri, T., & Pitman, R. K. (2000) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.109.2.290 · Cited by 653 · see citing works
Back to the future: The organizational-activational hypothesis adapted to puberty and adolescence
Schulz, K. M., Molenda-Figueira, H. A., & Sisk, C. L. (2009) · Hormones and Behavior · doi:10.1016/j.yhbeh.2009.03.010 · Cited by 587 · see citing works
Attention and executive functions in remitted major depression patients
Paelecke-Habermann, Y., Pohl, J., & Leplow, B. (2005) · Journal of Affective Disorders · doi:10.1016/j.jad.2005.09.006 · Cited by 487 · see citing works
Avoidance and depression: the construction of the Cognitive–Behavioral Avoidance Scale
Ottenbreit, N. D., & Dobson, K. S. (2004) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00140-2 · Cited by 457 · see citing works
Gender differences in social anxiety disorder: A review
Asher, M., Asnaani, A., & Aderka, I. M. (2017) · Clinical Psychology Review · doi:10.1016/j.cpr.2017.05.004 · Cited by 457 · see citing works
Estrous cycle phase and gonadal hormones influence conditioned fear extinction
Milad, M. R., Igoe, S. A., Lebron-Milad, K., & Novales, J. E. (2009) · Neuroscience · doi:10.1016/j.neuroscience.2009.09.011 · Cited by 417 · see citing works
Wacker, J., Dillon, D. G., & Pizzagalli, D. A. (2009) · NeuroImage · doi:10.1016/j.neuroimage.2009.01.058 · Cited by 405 · see citing works
Lukas, M., Toth, I., Reber, S. O., Slattery, D. A., Veenema, A. H., & Neumann, I. D. (2011) · Neuropsychopharmacology · doi:10.1038/npp.2011.95 · Cited by 403 · see citing works
Hofmann, S. G. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.04.009 · Cited by 397 · see citing works
Sex differences in anxiety and emotional behavior
Donner, N. C., & Lowry, C. A. (2013) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-013-1271-7 · Cited by 379 · see citing works
Nakajima, M., Görlich, A., & Heintz, N. (2014) · Cell · doi:10.1016/j.cell.2014.09.020 · Cited by 262 · see citing works
A Cortical Circuit for Sexually Dimorphic Oxytocin-Dependent Anxiety Behaviors
Li, K., Nakajima, M., Ibañez-Tallon, I., & Heintz, N. (2016) · Cell · doi:10.1016/j.cell.2016.08.067 · Cited by 234 · see citing works
Duque-Wilckens, N., Steinman, M. Q., Busnelli, M., Chini, B., Yokoyama, S., Pham, M., Laredo, S. A., Hao, R., Perkeybile, A. M., Minie, V. A., et al. (2018) · Biological Psychiatry · doi:10.1016/j.biopsych.2017.08.024 · Cited by 181 · see citing works
Females do not express learned helplessness like males do
Dalla, C., Edgecomb, C., Whetstone, A. S., & Shors, T. J. (2008) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301533 · Cited by 174 · see citing works
Baratta, M. V., Christianson, J. P., Gomez, D. M., Zarza, C. M., Amat, J., Masini, C. V., Watkins, L. R., & Maier, S. F. (2007) · Neuroscience · doi:10.1016/j.neuroscience.2007.03.042 · Cited by 156 · see citing works
Maier, S. F. (2015) · Neurobiology of Stress · doi:10.1016/j.ynstr.2014.09.003 · Cited by 143 · see citing works
Extrahypothalamic oxytocin neurons drive stress-induced social vigilance and avoidance
Duque-Wilckens, N., Torres, L. Y., Yokoyama, S., Minie, V. A., Tran, A. M., Petkova, S. P., Hao, R., Ramos-Maciel, S., Rios, R. A., Jackson, K., et al. (2020) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2011890117 · Cited by 139 · see citing works
Sex Differences in Anxiety Disorders: A Review
University of Texas Health Science Center at Houston, & Jalnapurkar, I. (2018) · Psychiatry, Depression & Anxiety · doi:10.24966/pda-0150/100011 · Cited by 139 · see citing works
Higher Levels of Basal Serial CSF Cortisol in Combat Veterans With Posttraumatic Stress Disorder
Baker, D. G., Ekhator, N. N., Kasckow, J. W., Dashevsky, B., Horn, P. S., Bednarik, L., & Geracioti, T. D. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.5.992 · Cited by 135 · see citing works
Sex differences in stress regulation of arousal and cognition
Bangasser, D. A., Eck, S. R., Telenson, A. M., & Salvatore, M. (2018) · Physiology & Behavior · doi:10.1016/j.physbeh.2017.09.025 · Cited by 133 · see citing works
Self-citationSex-specific effects of stress on oxytocin neurons correspond with responses to intranasal oxytocin
Steinman, M. Q., Duque-Wilckens, N., Greenberg, G. D., Hao, R., Campi, K. L., Laredo, S. A., Laman-Maharg, A., Manning, C. E., Doig, I. E., Lopez, E. M., et al. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2015.10.007 · Cited by 131 · see citing works
Helpman, L., Marin, M.-F., Papini, S., Zhu, X., Sullivan, G. M., Schneier, F., Neria, M., Shvil, E., Malaga Aragon, M. J., Markowitz, J. C., et al. (2016) · NeuroImage: Clinical · doi:10.1016/j.nicl.2016.10.007 · Cited by 121 · see citing works
Trainor, B. C., Takahashi, E. Y., Campi, K. L., Florez, S. A., Greenberg, G. D., Laman-Maharg, A., Laredo, S. A., Orr, V. N., Silva, A. L., & Steinman, M. Q. (2013) · Hormones and Behavior · doi:10.1016/j.yhbeh.2013.01.011 · Cited by 86 · see citing works
Effects of photoperiod and experience on aggressive behavior in female California mice
Silva, A. L., Fry, W. H. D., Sweeney, C., & Trainor, B. C. (2010) · Behavioural Brain Research · doi:10.1016/j.bbr.2009.12.038 · Cited by 76 · see citing works
Meeting report: can we make animal models of human mental illness?
Monteggia, L. M., Heimer, H., & Nestler, E. J. (2018) · Biological Psychiatry · doi:10.1016/j.biopsych.2018.02.010 · Cited by 60 · see citing works
Kobayashi, I., & Mellman, T. A. (2012) · Behavioral Sleep Medicine · doi:10.1080/15402002.2011.654296 · Cited by 49 · see citing works
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The menace of obesity to depression and anxiety prevalence
Fulton, S., Décarie-Spain, L., Fioramonti, X., Guiard, B., & Nakajima, S. (2022) · Trends in Endocrinology & Metabolism · doi:10.1016/j.tem.2021.10.005 · Cited by 441 · see citing works
Farhane-Medina, N. Z., Luque, B., Tabernero, C., & Castillo-Mayén, R. (2022) · Science Progress · doi:10.1177/00368504221135469 · Cited by 409 · see citing works
Haltigan, J. D., Pringsheim, T. M., & Rajkumar, G. (2023) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2022.152362 · Cited by 92 · see citing works
Sexual differentiation of neural mechanisms of stress sensitivity during puberty
Wright, E. C., Luo, P. X., Zakharenkov, H. C., Serna Godoy, A., Lake, A. A., Prince, Z. D., Sekar, S., Culkin, H. I., Ramirez, A. V., Dwyer, T., et al. (2023) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2306475120 · Cited by 34 · see citing works
Anxiety and Depression Symptoms among Youth Survivors of Childhood Sexual Abuse: A Network Analysis
Li, J., Jin, Y., Xu, S., Luo, X., Wilson, A., Li, H., Wang, X., Sun, X., & Wang, Y. (2023) · BMC Psychology · doi:10.1186/s40359-023-01275-3 · Cited by 29 · see citing works
An allostatic epigenetic memory on chromatin footprints after double-hit acute stress
Caradonna, S. G., Paul, M. R., & Marrocco, J. (2022) · Neurobiology of Stress · doi:10.1016/j.ynstr.2022.100475 · Cited by 13 · see citing works
Corvo, C., Mendez-David, I., Goutal, S., Saba, W., Bottlaender, M., Caillé, F., Hen, R., Colle, R., Corruble, E., Tournier, N., et al. (2025) · ACS Pharmacology & Translational Science · doi:10.1021/acsptsci.4c00621 · Cited by 7 · see citing works
- Authors
- Bangasser, D. A., & Cuarenta, A.
- Affiliations
- Temple University (US)
- Venue
- Nature Reviews Neuroscience
- Published
- 2021-09-20
- Volume
- 22
- Issue
- 11
- Pages
- 674-684
- ISSN
- 1471-003X (ISSN-L)
- 1471-0048
- OpenAlex
- W3200422364
- Cited by
- 479
- References
- 36
- Citations by year
- 2026: 102 · 2025: 117 · 2024: 115 · 2023: 83 · 2022: 60 · 2021: 2
- FWCI
- 9.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nature reviews. Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- sex differences, anxiety disorders, major depressive disorder, female rodents, neurobiology of anxiety, fear processing, arousal, social avoidance, learned helplessness, anhedonia, sex as a biological variable
- MeSH terms
- Animals, Anxiety, Brain, Depression, Female, Humans, Male, Nerve Net, Sex Characteristics
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