Sex differences in mental illness among adult men and women: An evaluation of four questions raised regarding the evidence on the higher rates of women

Abstract

In a paper which limited the definition of mental illness to non-organic disorders where there was acute distress and/or disorganization, Jeanette Tudor and I found that since World War II in western industrial societies the data from a variety of sources consistently indicated that women have higher rates of mental illness than men. This sex difference was attributed to differences in the sex and marital roles of men and women. The publication of this article produced a debate on a number of topics. First, an apparent contradiction in the literature was noted: while women manifest more psychiatric symptoms they appear to be as happy and satisfied as men. Second, questions have been raised about the reliability and validity of the data presented. Third, there have been investigations with somewhat conflicting results with regard to the role explanation suggested. And fourth, an alternative, primarily biological, explanation of the data has been proposed by Dohrenwend and Dohrenwend. The present paper reviews the evidence bearing on these four questions. It is concluded that, in toto, the evidence suggests that in our society women do have higher rates of mental illness than men and that this difference is due primarily to their sex and marital roles. However, it is clear that we know relatively little about the precise nature of the interaction of sex roles, marital roles, socialization and personality which produces the higher rates in women.