Shi Peixia, Yang Aigang, Zhao Qing, Chen Zhaohua, Ren Xiaomei, Dai Qin
Department of Nursing Psychology, Army Medical University, Chongqing, China.
CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China.
Front Psychiatry. 2021 Oct 25;12:589687. doi: 10.3389/fpsyt.2021.589687. eCollection 2021.
The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.
抑郁症中女性占优势的现象已有充分报道，但男性较高的自杀率和成瘾行为发生率以及女性较长的寿命对这一现象提出了挑战。因此，我们提出另一种假设“抑郁症自我报告症状的性别差异”，即轻度至中度抑郁症往往更多地由女性报告，而重度抑郁症和自杀往往更多地由男性报告。解释这种差异的潜在机制可能包括三个方面：雌激素水平与女性抑郁症发病高峰之间的协变、应对方式的性别差异（例如，男性相对情绪不表达和不寻求帮助）以及症状表型的性别差异（例如，男性抑郁症的非典型症状）。我们新提出的假设意味着男性抑郁症被忽视的诊断不足和治疗不足。为了有效诊断和及时治疗男性抑郁症，将男性抑郁症症状纳入相关诊断标准、鼓励男性表达负面情绪以及提高对男性自杀行为的认识至关重要。
