THE ORIGINS OF SEX-DIFFERENCES IN DEPRESSIVE DISORDER - BRIDGING THE GAP

The high prevalence of depressive disorder in women is well establishe d. However, it has not been convincingly explained. This reflects a mo re general failure of research to provide a comprehensive aetiological account of depression. The examination of the sex: difference can be used as a probe to evaluate how far we have gone in substantiating int egrated models of depressive disorder. In this paper, I review several lines of investigation in order to assess the relative importance of social, psychological and biological influences on the sex: difference in depression. These include the epidemiology of macrosocial variable s and age effects, and the exploration of relevant psychological attri butes, including temperament, personality, and attributional and copin g styles. We must also consider the experience of psychosocial adversi ty, and in particular the possibility of art increased susceptibility of women to some forms of stress. Both the tendency to affiliation and the requirement for social support seem stronger in women. There is a ppreciable direct and indirect evidence that the particular strains of the roles available to women may increase their risk of depression. B iological explanations tend to be couched in hormonal terms. However, the most convincing hormonal correlates of depressive disorder relate not to sex hormones but to corticosteroids and their control mechanism s. These do not appear to differ by sex. However, the greatest problem for biological explanations of the sex difference lies in the failure of genetic models to account for it. It is hard to conceive of a biol ogical substrate unaffected by genetic factors. Thus, while there seem s no doubt that biological factors are involved in the emergence of de pressive disorder, they do not appear to be responsible for the sex di fference. All told, the evidence for environmental effects is much bet ter for social than for physical factors, and a plausible case can be made for a developmental perspective involving the interaction of soci al experience and psychological attributes.