Gender-related treatment gap in depression among the elderly: a study on 18 European countries

Abstract

Abstract Background Depression is largely unrecognized and untreated, particularly among men. Help-seeking behaviors are known to differ between genders, yet, these discrepancies are expected to vary along the socioeconomic distribution. This study assesses the gender-related treatment gap for depression and analyzes how it varies with the socioeconomic status. Methods We used data from the Wave 6 (2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE) from 56,931 participants aged 50-80 from 18 European countries. Among those depressed (assessed by the EURO-D scale), we modelled previous diagnosis of an emotional problem by a doctor, as proxy for the treatment gap. First, a logistic regression with gender as the explanatory variable was performed, adjusting for age and country. Afterwards, employment and education were factored in and interacted with gender, to assess the differential association of these variables for men and women. Results Depression was more prevalent among women (35.5%) than men (19.8%). Among those depressed, women (18.9%) were more likely than men (13.9%) to have been previously diagnosed for an emotional problem (OR = 1.43, 95%CI=1.42-1.43). Compared to men, women had a lower likelihood of diagnosis among homemakers (OR = 0.50, 95%CI=0.49-0.52) and a higher likelihood when unemployed (OR = 2.18, 95%CI=2.16-2.20), employed (OR = 1.10, 95%CI=1.10-1.11), disabled (OR = 1.20, 95%CI=1.19-1.21) with low (OR = 1.26, 95%CI=1.25-1.27) or middle educational level (OR = 1.67, 95%CI=1.66-1.68). Conclusions Although depression is more frequent among women, results suggest a larger treatment gap among men. Low- and medium-educated men seem less likely to have been previously diagnosed, as well as those unemployed. Among women, those homemakers are less likely to have been diagnosed with depression. Key messages Depressed men are less likely to have been diagnosed, particularly those unemployed and less-educated. Among women, depression diagnosis is less frequent when they are homemakers.