Abstract
BackgroundThe higher prevalence of major depressive disorder (MDD) in females relative to males is well-established. Some authors have posited this difference arises to divergent symptom profiles in females vs. males. However, empirical tests of this hypothesis have yielded equivocal results. Here, we investigate sex differences in MDD of individual symptoms and symptom networks in a treatment-seeking sample. MethodsWe assessed depressive symptoms using Hamilton Depression Rating Scale (HDRS-17) in 590 treatment-seeking adults with MDD (300 females). We examined group differences in symptom endorsement. We investigated symptom networks and estimated Gaussian Graphical Models. Finally, we compared the female and male networks using the Network Comparison Test. ResultsFemales scored significantly higher in psychological anxiety (p <0.001; rB = -0.155), somatic anxiety (p = .001; rB = -0.150) and feelings of guilt (p = .002; rB = -0.139). Male and female patients did not differ in depression sum scores. There were no sex differences in network structure or global strength. LimitationsOur study was sufficiently powered to detect only medium sized symptom differences. The generalizability of our study is limited to clinical samples and further studies are needed to investigate if findings also translate to outpatient samples. ConclusionFemales reported elevated anxiety symptoms and guilt. Clinicians should assess these symptom differences and tailor treatment to individual symptom profiles. No differences between sexes emerged in MDD network structures, indicating that features may be more similar than previously assumed. Sex differences in psychopathological features of MDD are important for future research and personalized treatment.
Highlights
The increased prevalence of major depressive disorder (MDD) in females compared to males has been reported consistently over time and in different populations (Kessler et al, 2003; Lim et al, 2018)
The current study investigated sex differences in depressive symptom profiles and in the corresponding symptom network structure in an adult, treatment-seeking population suffering from major depressive disorder
In accordance with a meta-analysis on sex differences in depressive symptoms by Cavanagh et al (2017), we found that females reported more anxiety than males
Summary
The increased prevalence of major depressive disorder (MDD) in females compared to males has been reported consistently over time and in different populations (Kessler et al, 2003; Lim et al, 2018). The reason for these differences in prevalence has been attributed to various underlying sex differences, for example in neurobiology (Rubinow and Schmidt, 2019) and the prevalence of subtypes of depression (Silverstein et al, 2017). CONCLUSION: Females reported elevated anxiety symptoms and guilt Clinicians should assess these symptom differences and tailor treatment to individual symptom profiles.
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