Patient gender differences in the diagnosis of depression in primary care

Our purpose was to explore why women are more likely than men to be diagnos ed as depressed by their primary care physician. Women were found to have m ore depressive symptoms as self-reported on the Beck Depression Inventory ( BDI). Women having high BDI scores (reflecting significant depression) were more likely than men with high BDI scores to be diagnosed by their primary care physician (p = 0.0295). Female patients made significantly more visit s to the clinic than men. For both sexes, patients with greater numbers of primary care clinic visits were more likely to be diagnosed as depressed. L ogistic regression revealed that gender has both a direct and indirect (thr ough increased use) effect on the likelihood of being diagnosed as depresse d. Patient BDI score, clinic use, educational level, and marital status wer e all significantly related to the diagnosis of depression. Controlling all other independent variables, women were 72% more likely than men to be ide ntified as depressed, but this effect did not achieve statistical significa nce (p = 0.0981). In gender-specific analyses, BDI and clinic use were agai n significantly related to the diagnosis of depression for both sexes. Howe ver, educational and marital status predicted depression diagnosis only for women. Separated, divorced, or widowed women were almost five times as lik ely to be diagnosed as depressed as those who were never married, all other factors being equal. Clinic use and BDI scores were found to be important correlates of the diagnosis of depression. There was some evidence of possi ble gender bias in the diagnosis of depression.