Differences in depressive symptom profile between males and females.

Background: It is widely held that there are no differences in the symptom profile of male and female depression. Studies to date that have found differences have used different methodologies and had inconsistent findings. Here we compare the clinical profile of major depression for men and women from a sample of almost 600 well-characterized individuals with recurrent major depressive disorder (MDD).

Methods: Subjects were recruited as part of a large genetic-epidemiological study of MDD. Clinical assessments included semi-structured interviews and case-note review. Clinical profiles during 'worst ever' (WE) depressive episode were scored using the OPCRIT checklist. Profiles for 199 males were compared to 399 females.

Results: Females with depression tended to have an earlier age-at-onset (p<0.0001), exhibited more frequent depressive episodes (p<0.005), had a greater number of depressive symptoms (p<0.001), and reported much higher rates of atypical depressive features (p<0.007) during their WE episode of depression. Logistic regression analysis identified that earlier age-at-onset of depression, excessive self-reproach and diminished libido were the best predictors of female depression.

Limitations: Retrospective recall by subjects of depressive symptoms, which may be prone to recall bias.

Conclusions: There are differences in the clinical course and symptom profile of male and female depression. Further study is required to identify the biological correlates of these differences and to characterize their clinical importance.