The three-year persistence of depressive symptoms in men and women
Introduction
The sex difference in depression is well known. Women report more symptoms of depression than men (Nolen-Hoeksema, 1990, Weissman and Klerman, 1992). The prevalence of depression among women is approximately twice that found among men. Recent epidemiological research confirms this general conclusion (Lépine et al., 1997). Due to a lack of longitudinal studies of the general population, less is known, however, both about the course of depression and about sex differences in the persistence of depressive behavior. The purpose of this article is to, partially, fill this gap. Using information from interviews at five occasions separated by intervals of one year (1992 to 1996) sex differences in the course of depression are examined. Furthermore, the stability of the findings over several social categories are investigated. Attention is given to the mediating role of family related characteristics, such as marital status and work related characteristics, such as employment status and level of education. Although the aim of this study, the determination of a sex difference in depression persistence, is mainly descriptive the results of the analyses are not without theoretical significance. In the discussion section, these theoretical implications are given some consideration.
Section snippets
Previous research
Follow-up studies of former patients have yielded a less favorable outcome (or higher chronicity) in women (Amenson and Lewinshon, 1981, Dunn and Skuse, 1981, Mann et al., 1981, Ceroni et al., 1984, Angst and Dobler-Mikola, 1985, Frank et al., 1988) or the absence of sex differences in recovery (Keller and Shapiro, 1981). However, only a minority of women and men with depression receives treatment. Furthermore, sex differences in the use of treatment facilities are well known, with women
Subjects
The panel study of Belgian Households (PSBH) was designed to produce longitudinal data for a broad range of socioeconomic and family-related sociological items. The 8744 participants in the first wave of the PSBH (1992) were selected using a stratified multistage area probability sample of private households. All adults (aged 16 or older) of 4439 households were included. Residents of collective households — e.g. institutionalized persons — were excluded. Subsequent interviews were collected at
Results
In Table 2a data on persistence by sex, educational level, marital status, age, and employment status are presented.
Women show more depression persistence. The sex difference in chronicity is significant, independent of the time interval used. Using logistic regression the sex ratio is estimated at 2.28 (, p<0.001) for one-year depression persistence, 2.08 (, p=<0.001) for two-year persistence, and 3.5 (, p<0.001) for three-depression persistence.
Depression persistence, sociodemographic characteristics and T1-depression severity: logistic regression analysis
To evaluate the independent contribution of the sociodemographic and clinical characteristics a series of logistic regression analysis was performed. The results of the estimation of the first model in Table 4 confirm the existence of a sex difference in three-year depression persistence. The parameter estimate is highly significant, leading to an estimated odds ratio of 3.48. This ratio is substantially higher than the aforementioned sex ratios of one-year and two year depression chronicity,
Discussion and conclusion
To date, only a handful of studies of the general population use a prospective design to estimate the persistence of depression in women and men (Surtees et al., 1986, Sargeant et al., 1990, Ernst and Angst, 1992, Kawakami et al., 1995, Bracke, 1998). The results of the investigations of Surtees et al., 1986, Ernst and Angst, 1992, Kawakami et al., 1995 are limited because only particular subgroups of the general population are sampled. In contrast, Sargeant et al., 1990, Bracke, 1998 use
Acknowledgements
The data for this study were provided by the Steunpunt Gezinsdemografisch Panel: PSBH/golf1 (1992), PSBH/golf2 (1993), PSBH/golf3 (1994), PSBH/golf4 (1995), PSBH/golf5 (1996).
References (53)
- et al.
Chronicity in major depression: a naturalistic prospective study
Journal of Affective Disorders
(1984) - et al.
Sex and depression in the National Comorbidity Survey. I. Lifetime prevalence, chronicity and recurrence
Journal of Affective Disorders
(1993) - et al.
Sex and depression in the National Comorbidity Survey. II. Cohort effects
Journal of Affective Disorders
(1994) Social subordination stress, behavior and central monoaminergic function in female Cynomolgus monkeys
Biological Psychiatry
(1998)- et al.
An investigation into the observed sex difference in prevalence of unipolar depression
Journal of Abnormal Psychology
(1981) Diagnostic and Statistical Manual of Mental disorders
(1987)The natural history of depressive symptoms
Research in Community Mental Health
(1985)- et al.
Social psychological aspects of reporting behavior: lifetime depressive episode reports
Journal of Health and Social Behavior
(1987) - et al.
The Zurich study: a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. I. Problem, methodology
European Archives of Psychiatry and Neurological Sciences
(1984) - et al.
The Zurich study: A prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. IV. Recurrent and nonrecurrent depression
European Archives of Psychiatry and Neurological Sciences
(1985)