The Epidemiology of Depression among Women

doi:10.1017/CBO9780511841262.004

2 - The Epidemiology of Depression among Women

Published online by Cambridge University Press: 05 June 2012

Ronald C. Kessler

Edited by

Corey L. M. Keyes and

Sherryl H. Goodman

Show author details

Ronald C. Kessler: Affiliation:
Department of Health Care Policy, Harvard Medical School, Cambridge, Massachusetts
Corey L. M. Keyes: Affiliation:
Emory University, Atlanta
Sherryl H. Goodman: Affiliation:
Emory University, Atlanta

Book contents

Get access

Summary

Nonbipolar major depression is estimated by the World Health Organization (WHO) Global Burden of Disease (GBD) Study to be the leading cause of disease-related disability among women in the world today (Murray & Lopez, 1996). This conclusion is based on epidemiological data that have documented a high prevalence of major depression among women around the world in conjunction with estimates of disease burden based on expert judgements. This chapter reviews the epidemiological research that underlies the WHO GBD estimates as well as more recent epidemiological research on women and depression. The discussion begins with a review of basic descriptive epidemiological patterns and then turns to epidemiological evidence about the cause of the higher prevalence of depression among women than men.

PREVALENCE

The fact that women have a higher prevalence of depression than do men is one of the most widely documented findings in psychiatric epidemiology, having been found throughout the world using a variety of diagnostic schemes and interview methods (Andrade et al., 2003; Nolen-Hoeksema, 1987). The prevalence of major depression among women in community epidemiological studies is typically estimated to be between one and a half and three times that of men, although there is enormous variation in the estimated total population prevalence of major depression across these studies. Lifetime prevalence estimates of major depressive episode range between 6 and 17%. Twelve-month prevalence estimates range between 1 and 10%. Current prevalence estimates range between less than 1 and 6%.

Type: Chapter
Information: Women and Depression
A Handbook for the Social, Behavioral, and Biomedical Sciences
, pp. 22 - 38

DOI: https://doi.org/10.1017/CBO9780511841262.004 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Agrawal, A., Jacobson, K. C., Gardner, C. O., Prescott, C. A., & Kendler, K. S. (2004). A population based twin study of sex differences in depressive symptoms. Twin Research, 7, 176–181CrossRef Google Scholar PubMed

Almeida, D. M., & Kessler, R. C. (1998). Everyday stressors and gender differences in daily distress. Journal of Personality and Social Psychology, 75, 670–680CrossRef Google Scholar PubMed

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV), 4th ed. Washington, DC: American Psychiatric Association; 1994

Andrade, L., Caraveo-Anduaga, J. J., Berglund, P., Bijl, R. V., Graaf, R., Vollebergh, W.. (2003). The epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. International Journal of Methods in Psychiatric Research, 12, 3–21CrossRef Google Scholar PubMed

Angold, A., Costello, E. J., Erkanli, A., & Worthman, C. W. (1999). Pubertal changes in hormone levels and depression in girls. Psychological Medicine, 29, 1043–1053CrossRef Google Scholar PubMed

Angold, A., Costello, E. J., & Worthman, C. W. (1998). Puberty and depression: The roles of age, pubertal status, and pubertal timing. Psychological Medicine, 28, 51–61CrossRef Google Scholar PubMed

Angst, J., & Merikangas, K. (1997). The depressive spectrum: Diagnostic classification and course. Journal of Affective Disorders, 45, 31–39CrossRef Google Scholar PubMed

Arnold, L. M. (2003). Gender differences in bipolar disorder. Psychiatric Clinics of North America, 26, 595–620CrossRef Google Scholar PubMed

Barnett, R. C., Biene, G. K., & Baruc, G. K. (1987). Gender and stress. New York: The Free PressGoogle Scholar

Benazzi, F. (2004). Intra-episode hypomanic symptoms during major depression and their correlates. Psychiatry and Clinical Neurosciences, 58, 289–294CrossRef Google Scholar PubMed

Blazer, D. G., Kessler, R. C., McGonagle, K. A., & Swartz, M. S. (1994). The prevalence and distribution of major depression in a national community sample: The National Comorbidity Survey. American Journal of Psychiatry, 151, 979–986Google Scholar

Bosworth, H. B., Bastian, L. A., Kuchibhatla, M. N., Steffens, D. C., McBride, C. M., Skinner, C. S.. (2001). Depressive symptoms, menopausal status, and climacteric symptoms in women at midlife. Psychosomatic Medicine, 63, 603–608CrossRef Google Scholar PubMed

Breslau, N. (1995). Sex differences in depression: A role for preexisting anxiety. Psychiatry Research, 58, 1–12CrossRef Google Scholar PubMed

Brown, G. W., Harris, T. O., & Eales, M. J. (1993). Aetiology of anxiety and depressive disorders in an inner-city population: 2. Comorbidity and adversity. Psychological Medicine, 23, 155–165CrossRef Google Scholar

Burt, V. K., & Rasgon, N. (2004). Special considerations in treating bipolar disorder in women. Bipolar Disorders, 6, 2–13CrossRef Google Scholar PubMed

Cross-National Collaborative Group. (1992). The changing rate of major depression: Cross-national comparisons. Journal of the American Medical Association, 268, 3098–3105CrossRef

Cullberg, J. (1972). Mood changes and menstrual symptoms with different gestagen/estrogen combinations. A double blind comparison with placebo. Acta Psychiatrica Scandinavica, Supplementum, 236, 1–86Google Scholar

Demyttenaere, K., Bruffaerts, R., Posada-Villa, J., Gasquet, I., Kovess, V., Lepine, J. P.. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of the American Medical Association, 291, 2581–2590Google Scholar PubMed

Dryfoos, J. G. (1990). Adolescents at risk: Prevalence and prevention. New York: Oxford University PressGoogle Scholar

Eaves, L. J., Silberg, J. L., Meyer, J. M., Maes, H. H., Simonoff, E., Pickles, A.. (1997). Genetics and developmental psychopathology: II. The main effects of genes and environment on behavioral problems in the Virginia Twin Study of Adolescent Behavioral Development. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 38, 965–980CrossRef Google Scholar

Ernst, C., & Angst, J. (1992). The Zurich study Ⅻ. Sex difference in depression. Evidence from longitudinal epidemiological data. European Archives of Psychiatry and Clinical Neuroscience, 241, 222–230CrossRef Google Scholar

Fava, M. (1997). Psychopharmacologic treatment of pathologic aggression. Psychiatric Clinics of North America, 20, 427–451CrossRef Google Scholar PubMed

Fava, M. (1998). Depression with anger attacks. Journal of Clinical Psychiatry, 59 Suppl 18, 18–22Google Scholar PubMed

Ge, X., Conger, R. D., & Elder, G. H. Jr. (1996). Coming to age too early: Pubertal influences on girls' vulnerability to psychological distress. Child Development, 67, 3386–3400CrossRef Google Scholar PubMed

Giuffra, L. A., & Risch, N. (1994). Diminished recall and the cohort effect of major depression: A simulation study. Psychological Medicine, 24, 375–383CrossRef Google Scholar PubMed

Goodwin, F. K., & Jamison, K. J. (1990). Manic-depressive illness. New York: Oxford University PressGoogle Scholar

Gotlib, I. H., Whiffen, V. E., Mount, J. H., Milne, K., & Cordy, N. I. (1989). Prevalence rates and demographic characteristics associated with depression in pregnancy and the postpartum. Journal of Consulting and Clinical Psychology, 57, 269–274CrossRef Google Scholar PubMed

Gove, W. R. (1972). The relationship between sex roles, marital status, and mental illness. Social Forces, 51, 34–44CrossRef Google Scholar

Gove, W. R., & Geerken, M. R. (1977). Response bias in surveys of mental health: An empirical investigation. American Journal of Sociology, 82, 1289–1317CrossRef Google Scholar

Hagnell, O., Lanke, J., Rorsman, B., & Ojesjo, L. (1982). Are we entering an age of melancholy? Depressive illness in a prospective epidemiologic study over 25 years: The Lunby Study, Sweden. Psychological Medicine, 12, 279–289CrossRef Google Scholar

Hamburg, D. A. (1992). Today's children: Creating a future for a generation in crisis. New York: Times BooksGoogle Scholar

Hankin, B. L., & Abramson, L. Y. (1999). Development of gender differences in depression: Description and possible explanations. Annals of Medicine, 31, 372–379CrossRef Google Scholar PubMed

Hayward, C., Gotlib, I. H., Schraedley, P. K., & Litt, I. F. (1999). Ethnic differences in the association between pubertal status and symptoms of depression in adolescent girls. Journal of Adolescent Health, 25, 143–149CrossRef Google Scholar PubMed

Hettema, J. M., Prescott, C. A., & Kendler, K. S. (2003). The effects of anxiety, substance use and conduct disorders on risk of major depressive disorder. Psychological Medicine, 33, 1423–1432CrossRef Google Scholar PubMed

Hunter, M., Battersby, R., & Whitehead, M. (1986). Relationships between psychological symptoms, somatic complaints and menopausal status. Maturitas, 8, 217–228CrossRef Google Scholar PubMed

Kendler, K. S., Davis, C. G., & Kessler, R. C. (1997). The familial aggregation of common psychiatric and substance abuse disorders in the National Comorbidity Survey: A family history study. British Journal of Psychiatry, 170, 541–548CrossRef Google Scholar PubMed

Kendler, K. S., Kuhn, J., & Prescott, C. A. (2004). The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression. American Journal of Psychiatry, 161, 631–636CrossRef Google Scholar PubMed

Kendler, K. S., & Prescott, C. A. (1999). A population-based twin study of lifetime major depression in men and women. Archives of General Psychiatry, 56, 39–44CrossRef Google Scholar PubMed

Kessler, R. C. (2000). Gender differences in major depression: Epidemiologic findings. In Frank, E. (Ed.), Gender and its effect on psychopathology (pp. 61–84). Washington, DC: American Psychiatric PressGoogle Scholar

Kessler, R. C., & Magee, W. J. (1993). Childhood adversities and adult depression: Basic patterns of association in a US National Survey. Psychological Medicine, 23, 679–690CrossRef Google Scholar

Kessler, R. C., McGonagle, K. A., Nelson, C. B., Hughes, M., Swartz, M. S., & Blazer, D. G. (1994). Sex and depression in the National Comorbidity Survey II: Cohort effects. Journal of Affective Disorders, 30, 15–26CrossRef Google Scholar PubMed

Kessler, R. C., & McLeod, J. D. (1984). Sex differences in vulnerability to undesirable life events. American Sociological Review, 49, 620–631CrossRef Google Scholar

Kessler, R. C., & McRae, J. A. Jr. (1981). Trends in the relationship between sex and psychological distress: 1957–1976. American Sociological Review, 46, 443–452CrossRef Google Scholar PubMed

Kessler, R. C., Nelson, C. B., McGonagle, K. A., Liu, J., Swartz, M. S., & Blazer, D. G. (1996). Comorbidity of DSM-III-R major depressive disorder in the general population: Results from the US National Comorbidity Survey. British Journal of Psychiatry, 168, 17–30Google Scholar

Kessler, R. C., Wittchen, H.-U., Abelson, J. M., McGonagle, K. A., Schwarz, N., Kendler, K. S.. (1998). Methodological studies of the Composite International Diagnostic Interview (CIDI) in the U.S. National Comorbidity Survey. International Journal of Methods in Psychiatric Research, 7, 33–55CrossRef Google Scholar

Kessler, R. C., Zhao, S., Blazer, D. G., & Swartz, M. S. (1997). Prevalence, correlates and course of minor depression and major depression in the NCS. Journal of Affective Disorders, 45, 19–30CrossRef Google Scholar

Klein, D. N., Durbin, C. E., Shankman, S. A., & Santiago, N. J. (2002). Depression and personality. In Gotlib, I. H. & Hammen, C. L. (Eds.), Handbook of depression. (pp. 115–140). New York: GuilfordGoogle Scholar

Lennon, M. C. (1987). Sex differences in distress: the impact of gender and work roles. Journal of Health and Social Behavior, 28, 290–305CrossRef Google Scholar PubMed

Merikangas, K. R., Risch, N. J., & Weissman, M. M. (1994). Comorbidity and co-transmission of alcoholism, anxiety and depression. Psychological Medicine, 24, 69–80CrossRef Google Scholar PubMed

Mirowsky, J., & Ross, C. E. (1989). Social causes of psychological distress. New York: Aldine De GruyterGoogle Scholar

Moller-Leimkuhler, A. M., Bottlender, R., Strauss, A., & Rutz, W. (2004). Is there evidence for a male depressive syndrome in inpatients with major depression? Journal of Affective Disorders, 80, 87–93CrossRef Google Scholar PubMed

Monroe, S. M., & Hadjiyannakis, K. (2002). The social environment and depression: focusing on severe life stress. In Gotlib, I. H. & Hammen, C. L. (Eds.), Handbook of depression (pp. 314–340). New York: GuilfordGoogle Scholar

Mueller, T. I., Leon, A. C., Keller, M. B., Solomon, D. A., Endicott, J., Coryell, W.. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. American Journal of Psychiatry, 156, 1000–1006Google Scholar PubMed

Mullen, P. E., Martin, J. L., Anderson, J. C., Romans, S. E., & Herbison, G. P. (1996). The long-term impact of the physical, emotional, and sexual abuse of children: A community study. Child Abuse & Neglect, 20, 7–21CrossRef Google Scholar PubMed

Nazroo, J. Y., Edwards, A. C., & Brown, G. W. (1997). Gender differences in the onset of depression following a shared life event: A study of couples. Psychological Medicine, 27, 9–19CrossRef Google Scholar PubMed

Nolen-Hoeksema, S. (1987). Sex differences in unipolar depression: Evidence and theory. Psychological Bulletin, 101, 259–282CrossRef Google Scholar PubMed

Nolen-Hoeksema, S. (1990). Sex differences in depression. Palo Alto, CA: Stanford University Press

Pasquini, M., Picardi, A., Biondi, M., Gaetano, P., & Morosini, P. (2004). Relevance of anger and irritability in outpatients with major depressive disorder. Psychopathology, 37, 155–160CrossRef Google Scholar PubMed

Robb, J. C., Young, L. T., Cooke, R. G., & Joffe, R. T. (1998). Gender differences in patients with bipolar disorder influence outcome in the medical outcomes survey (SF-20) subscale scores. Journal of Affective Disorders, 49, 189–193CrossRef Google Scholar PubMed

Sanathara, V. A., Gardner, C. O., Prescott, C. A., & Kendler, K. S. (2003). Interpersonal dependence and major depression: Aetiological inter-relationship and gender differences. Psychological Medicine, 33, 927–931CrossRef Google Scholar PubMed

Sichel, D. (2000). Postpartum psychiatric disorders. In Steiner, M., Yonkers, K. A., & Eriksson, E. (Eds.), Mood disorders in Women (pp. 313–328). London: Martin DunitzGoogle Scholar

Silberg, J., Pickles, A., Rutter, M., Hewitt, J., Simonoff, E., Maes, H.. (1999). The influence of genetic factors and life stress on depression among adolescent girls. Archives of General Psychiatry, 56, 225–232CrossRef Google Scholar PubMed

Simmons, R. G., & Blyth, D. A. (1987). Moving into adolescence: The impact of pubertal change and school context. New York: Aldine de GruyterGoogle Scholar

Simon, G. E., & VonKorff, M. (1995). Recall of psychiatric history in cross-sectional surveys: Implications for epidemiologic research. Epidemiological Reviews, 17, 221–227CrossRef Google Scholar PubMed

Simpson, H. B., Nee, J. C., & Endicott, J. (1997). First-episode major depression: Few sex differences in course. Archives of General Psychiatry, 54, 633–639CrossRef Google Scholar PubMed

Srole, L., & Fisher, A. K. (1980). The Midtown Manhattan Longitudinal Study vs ‘the Mental Paradise Lost’ doctrine. A controversy joined. Archives of General Psychiatry, 37, 209–221CrossRef Google Scholar PubMed

Weissman, M. M., Bland, R., Joyce, P. R., & Newman, S. (1993). Sex differences in rates of depression: Cross-national perspectives [Special Issue: Toward a new psychobiology of depression in women]. Journal of Affective Disorders, 29, 77–84CrossRef Google Scholar

Wichstrom, L. (1999). The emergence of gender difference in depressed mood during adolescence: the role of intensified gender socialization. Developmental Psychology, 35, 232–245CrossRef Google Scholar PubMed

Wilhelm, K., Parker, G., & Hadzi-Pavlovic, D. (1997). Fifteen years on: Evolving ideas in researching sex differences in depression. Psychological Medicine, 27, 875–883CrossRef Google Scholar PubMed

Wisner, K. L., Peindl, K., & Hanusa, B. H. (1993). Relationship of psychiatric illness to childbearing status: A hospital-based epidemiologic study. Journal of Affective Disorders, 28, 39–50CrossRef Google Scholar PubMed

World Health Organization. The ICD-10 Classification of Mental and Behavioral Disorders: Diagnostic Criteria for Research. Geneva, Switzerland: World Health Organization; 1993

Yonkers, K. A., Bradshaw, K. D., & Halbreich, U. (2000). Oestrogens, progestins and mood. In Steiner, M., Yonkers, K. A., & Eriksson, E. (Eds.), Mood disorders in women (pp. 207–232). London: Martin DunitzGoogle Scholar

Young, M. A., Fogg, L. F., Scheftner, W. A., Keller, M. B., & Fawcett, J. A. (1990). Sex differences in the lifetime prevalence of depression. Journal of Affective Disorders, 18, 187–192CrossRef Google Scholar PubMed

Zweifel, J. E., & O'Brien, W. H. (1997). A meta-analysis of the effect of hormone replacement therapy upon depressed mood. Psychoneuroendocrinology, 22, 189–212CrossRef Google Scholar PubMed