Is any female preponderance in depression secondary to a primary female preponderance in anxiety disorders?

Objective: National community studies consistently identify higher rates of both depressive and anxiety disorders in women. The female preponderance i n depression could be primary or, alternatively, a sex difference in anxiet y could determine the differential depression rates. We therefore pursue wh ether the female preponderance in depression is secondary to a female prepo nderance in anxiety disorders in a community sample. Method: We analyse relevant data from the National Comorbidity Study (NCS) database, examining in particular whether sex differences in anxiety there those meeting criteria for panic disorder, agoraphobia without panic disord er, generalized anxiety and social phobia) influenced sex differences in th e prevalence of both major depression and dysthymia. Results: Survival analyses indicated that, for both major depression and dy sthymia, and within subsamples of those with early onset and late onset dep ression, both female sex and a preceding anxiety disorder made significant contributions, with preceding anxiety making the consistently stronger cont ribution of the two. Conclusion: A proportion of the female preponderance in major depression an d dysthymia in the general community appears determined by a primary sex di fference in anxiety.