Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória (EMESCAM), Vitória, Brazil.
Department of Cardiology, Guangdong Provincial People's Hospital, Guandong Academy of Medical Sciences, China; Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, USA.
J Psychiatr Res. 2019 Apr;111:36-43. doi: 10.1016/j.jpsychires.2019.01.013. Epub 2019 Jan 11.
Depression is a serious mental health problem with a high prevalence among medical students. It is unclear whether a gender disparity of depression exists in this population, and whether gender inequality influences depression estimates by gender. We conducted a systematic search for published systematic reviews or meta-analyses in six databases and primary studies were obtained from those records. Studies were included if they contained original data on the prevalence of depression among male and female medical students. The Gender Inequality Index (GII) and the Human Development Index (HDI) were obtained from the United Nations Development Programme website. A random effects meta-analysis of the odds ratio for depression between females and males was conducted. Meta-regression analyses were conducted to assess the association of GII and prevalence of depression. The HDI was later incorporated in a multivariable model. We included a total of 106 studies and 84,119 students from 32 different countries. Female medical students are at higher odds of depression (OR = 1.30, 95% CI 1.17-1.44, p < 0.01). A significant correlation was found between GII and prevalence of depression for female (β = 0.24, p = 0.02) medical students, but not for male medical students. This association remained significant after adjusting for HDI. The female gender was associated with higher prevalence of depression in this population. The gender disparity in depression may be explained by the effect of gender inequality.
抑郁是一种严重的心理健康问题，在医学生中发病率很高。目前尚不清楚该人群中是否存在抑郁的性别差异，以及性别不平等是否会影响抑郁的性别估计。我们在六个数据库中进行了系统搜索，以寻找已发表的系统评价或荟萃分析，并从这些记录中获得了原始研究。如果研究包含了关于男、女医学生抑郁患病率的原始数据，则将其纳入研究。性别不平等指数（GII）和人类发展指数（HDI）从联合国开发计划署网站获得。采用随机效应荟萃分析评估了女性和男性抑郁发生率之间的比值比。进行了荟萃回归分析，以评估 GII 与抑郁患病率之间的关联。后来，HDI 被纳入多变量模型。我们共纳入了来自 32 个不同国家的 106 项研究和 84119 名学生。女医学生抑郁的可能性更高（OR=1.30，95%CI 1.17-1.44，p<0.01）。我们发现，GII 与女医学生的抑郁患病率之间存在显著相关性（β=0.24，p=0.02），但与男医学生之间无相关性。在调整了 HDI 后，这种关联仍然显著。在该人群中，女性性别与更高的抑郁患病率相关。抑郁的性别差异可能可以用性别不平等的影响来解释。
