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The role played by depression associated with somatic symptomatology in accounting for the gender difference in the prevalence of depression

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Abstract

Purpose

A variety of studies suggest the existence of a distinct phenotype of somatic depression, i.e., depression accompanied by significant somatic symptomatology. Previous research suggests that the gender difference in the prevalence of depression is primarily due to a difference in somatic depression. The aim of this study was to compare the gender difference in the prevalence of somatic depression and of depression not accompanied by significant somatic symptomatology (labelled “pure” depression) in two representative samples, the National Comorbidity Survey-Replication (NCS-R) and the Zurich Study.

Method

The gender difference in lifetime somatic depression was compared to that of pure depression based on analyses weighted back to the general population in two representative samples. The NCS-R analyses involved a narrow definition of somatic depression with items from the DSM criteria for depression—appetite, sleep, and fatigue. The analysis of the Zurich study added headaches, body image issues, and breathing difficulties to the criteria and comparison to atypical depression.

Results

In both samples, the gender difference in depressive prevalence was due to a large difference in somatic depression with other phenotypes showing little or no gender difference. The gender differences were found to be due to the somatic symptoms rather than the number of symptoms and were much larger for somatic than for atypical depression.

Conclusion

The gender difference in the prevalence of depression results from the higher prevalence among women of a specific phenotype, somatic depression.

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Acknowledgments

The public use dataset of the National Comorbidity Survey-Replication upon which some of the analyses presented here were sponsored by the National Institute of Mental Health and made available through the Inter-university Consortium for Political and Social Research. Statistical assistance in analyzing the NCS-R was provided by Helena Chang of Columbia University. The Zurich Study was partly supported by Grant 3200-050881.97/1 of the Swiss National Science Foundation (SNSF) which had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Psychology, City College of New York, New York, NY, 10031, USA

    B. Silverstein & T. Edwards

  2. Research Unit, Zurich University Psychiatric Hospital, Zurich, Switzerland

    A. Gamma & J. Angst

  3. Research Unit for Social and Clinical Psychiatry, Zurich University Psychiatric Hospital, Zurich, Switzerland

    V. Ajdacic-Gross

  4. Department of General and Social Psychiatry, Zurich University Psychiatric Hospital, Zurich, Switzerland

    W. Rossler

Authors
  1. B. Silverstein
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  2. T. Edwards
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  3. A. Gamma
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  4. V. Ajdacic-Gross
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  5. W. Rossler
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  6. J. Angst
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Correspondence to B. Silverstein.

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Silverstein, B., Edwards, T., Gamma, A. et al. The role played by depression associated with somatic symptomatology in accounting for the gender difference in the prevalence of depression. Soc Psychiatry Psychiatr Epidemiol 48, 257–263 (2013). https://doi.org/10.1007/s00127-012-0540-7

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  • DOI: https://doi.org/10.1007/s00127-012-0540-7

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