Gender differences in the prevalence of depression: a survey in primary care

Epidemiological surveys demonstrate that unipolar depression is more common in females than in males. Gender-specific cultural and social factors may contribute to the female preponderance. This study explores this possibilit y in a cross-cultural sample of general-practice patients systematically re cruited in the WHO study "Psychological Problems in Primary Care" conducted in 14 countries with identical sampling and assessment strategies. Althoug h absolute prevalence rates are broadly varying between centers proposing t hat the gender ratio is nearly constant with 1:2. The cultural context does not contribute substantially to the female preponderance. This study lends some support to previous observations that the magnitude of female prepond erance is associated with the number of symptoms associated with depression requested for caseness and inversely related to the degree of social impai rment. Matching social role variables (marital status, children, occupation al status) between females and males reduces the female excess by about 50% across all centers. Therefore, we conclude that social factors are inducin g part of the preponderance of females among depressed cases. (C) 1999 Else vier Science B.V. All rights reserved.