Depression in women.

Depression in treated samples shows an approximately 2:1 female predominance. The sex ratio is not due simply to more help-seeking behaviour in women, for it applies equally in studies of community prevalence. Differential acknowledgement and direction of distress may be a partial explanation, supported by male predominance of alcoholism and completed suicide, and by a possible recent increase in depression in young men. Biological mechanisms acting through hormonal effects on the brain are plausible, but hard to test. Epidemiological studies indicate that much of the excess occurs in married women aged 25-45 years with children. This strongly suggests social causation and highlights the vulnerable situation of young mothers. The full explanations for the sex difference are not yet clear, but are likely to combine factors related to expression of distress, biology and social situation.