Treatment Of Depression: Men And Women Are Different?

Weissman, Myrna M.

Using data from more than 1,000 twins from the vast birth-certificate-based Virginia Twin Registry of individuals born between 1940 and 1974, and assessing them with personal interviews at least 1 year apart, Kendler and Gardner have produced insights into psychosocial risk factors for women and men with major depression. The risk factors that had the greatest impact on liability to major depression in women were neuroticism, divorce, and absence of parental warmth, social supports, and marital satisfaction. For men, they were childhood sexual abuse, conduct disorder, drug abuse, prior history of major depression, and financial, occupational, and legal stressful life events. Matching between twin brothers and sisters on genetic and familial environmental background (the nature of the twin design), the authors conclude that women’s depressions are defined by deficiencies in caring relationships and interpersonal loss and men’s by failure to achieve expected instrumental goals and lowered self-worth.

At first glance, the results seem to fulfill sexist stereotypes. Maybe the results are due to where the study was carried out (in Virginia, a state with large rural areas), or to the older age range of the sample (39 to 73 years), or to the lack of racial diversity in the all-Caucasian sample. There are few possibilities for replicating these findings in samples of different composition. If the findings generalize to younger birth cohorts and diverse samples, these differences might make a difference in treatment. Understanding of gender differences in psychosocial risk could contribute to the search for personalized treatment.


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The American Journal of Psychiatry

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February 1, 2022