Abstract
Growing interest in gender-sensitive assessment of depression in men has seen the development of male-specific screening tools. These measures are yet to be subject to longitudinal latent modelling, which limits evidence about the ability of these tools to detect change, especially relative to established screening scales. In this study, three waves of data were collected from 234 men (38.35 years, SD = 14.09) including 3- and 6-month follow-up. Analyses focused on baseline differences and symptom trajectories for the Patient Health Questionnaire (PHQ; prototypic symptoms) and the Male Depression Risk Scale (MDRS; male-type symptoms). At baseline, men not accessing treatment reported higher MDRS scores relative to treatment-engaged men. There was no group difference for the PHQ. Internal consistency (α, ω) coefficients indicated comparable reliability for both measures across the three waves. Multidomain latent growth modelling, including current treatment engagement as a covariate, reported good model fit (CFI = 0.964, TLI = 0.986, RMSEA = 0.081, SRMR = 0.033) with differential findings for the PHQ and MDRS. Consistent with the baseline between-group analysis, current treatment effects were observed for the MDRS, but not the PHQ. Trajectory modelling for the MDRS indicated that greater severity resulted in slower improvement by 6 months. In contrast, there was no difference in the PHQ rate of change between baseline and 6 months. Findings support the psychometric utility of the MDRS as a male-specific symptom domain measure sensitive to both longitudinal change and potential treatment effects for symptomatic men, in ways not discernible by the PHQ. The MDRS may be a useful adjunctive screening tool for assessing men’s depression.
Highlights
Improved assessment of male depression is gaining momentum internationally as a means of reducing male suicide, and the construct of a distinct clinical phenotype is central to this work [1,2,3].Meta-analytic research shows that depression is a significant risk factor for suicide [4], with both male gender and the misuse of alcohol or drugs as important predictors [5]
Using three waves of data, we examined a multiple-group, multiple-domain latent growth model (MDLGM) comparing longitudinal trajectories for the Male Depression Risk Scale (MDRS) and Patient Health Questionnaire–Depression Module (PHQ; [31]), a widely used screening tool of the nine criterion symptoms contributing to a diagnosis of major depression [24]
Rate of MDRS change (2.749, p = 0.018). These findings suggest that MDRS scores were lower for men reporting current treatment, and men reporting current treatment reported a faster rate of improvement on MDRS scores by 2.749 points over the 6-month period compared to men not accessing treatment
Summary
Improved assessment of male depression is gaining momentum internationally as a means of reducing male suicide, and the construct of a distinct clinical phenotype is central to this work [1,2,3]. Meta-analytic research shows that depression is a significant risk factor for suicide [4], with both male gender and the misuse of alcohol or drugs as important predictors [5]. Underscoring the gendered nature of the problem, worldwide, suicide occurs 1.8-times more frequently among men than women [6]. The growing recognition of suicide as a gendered phenomenon has led to a greater focus on risk factors experienced by men [7,8]. Building on early qualitative work introducing the. Public Health 2020, 17, 7322; doi:10.3390/ijerph17197322 www.mdpi.com/journal/ijerph
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