Is gender a factor in psychiatrists' evaluation and treatment of patients with major depression?

Background: Gender differences in clinical assessment and treatment have be en reported in several areas of medicine. We examine whether differences ex ist in the routine outpatient psychiatric management of men and women with major depression. Methods: Psychiatrists practicing in the community comple ted case forms on a systematic sample of their adult outpatients with major depression. Comparisons an presented between male (n = 261) and female (n = 472) patients focusing on their background characteristics, clinical pres entation, assessment, and treatment. Significant gender disparities in asse ssment and treatment are also examined with respect to the gender of the tr eating psychiatrist. Results: Although male and female patients had general ly similar clinical profiles, a significantly greater proportion of males t han females had psychomotor retardation and substance use disorders. No sig nificant gender differences were observed in the assessment of depressive s ymptoms, psychiatric comorbidities, and treatment with antidepressant medic ations or psychotherapy. However, a significantly smaller percentage of dep ressed women than men received assessments of sexual function and medicatio n-related sexual side effects. Female patients were also less likely to hav e discussed their treatment preferences with their psychiatrists. Limitatio ns: Only a minority (33.2%) of psychiatrists invited to participate contrib uted patients to this study. The results are based on structured assessment s completed by practicing psychiatrists rather than patient self-assessment s or independent research assessments. Conclusions: Although we find overal l little evidence of gender bias in the clinical management of major depres sion, both male and female psychiatrists need to further explore sexual fun ction and treatment preferences in female patients. (C) 2001 Elsevier Scien ce B.V. All rights reserved.