Walther Andreas
Clinical Psychology and Psychotherapy, University of Zurich, Binzmühlestrasse 14, Zurich, 8050, Switzerland.
Psychotherapy Research, University of Graz, Graz, Austria.
Int J Equity Health. 2025 Jul 1;24(1):190. doi: 10.1186/s12939-025-02569-1.
The commentary explores the critical issue of gender bias in the diagnosis and treatment of depression, responding to the study by Bacigalupe et al. [3] that highlights disparities in mental health care for older adults. While acknowledging the study's strengths, it argues for deeper exploration into systemic biases and gendered symptomatology. Women's frequent healthcare interactions increase their likelihood of diagnosis and treatment, while men's reluctance to seek help often results in delayed or missed diagnoses, further complicated by male-typical externalizing symptoms like aggression, risk-taking, and substance abuse. Traditional diagnostic tools and criteria, rooted in prototypical internalizing symptoms, fail to adequately capture these male-typical presentations.The commentary also underscores the role of traditional masculinity ideologies (TMI) in shaping men's mental health behaviors. These socially constructed norms promote emotional suppression and self-reliance, exacerbating gender role conflict, dysfunction and discrepancy stress, thereby reducing help-seeking behaviors. High conformity to TMI correlates with poor therapeutic outcomes, higher dropout rates, and diminished treatment efficacy. The commentary critiques the dual bias evident in overmedicalizing women's mental health while neglecting masculine expressions of distress, advocating for gender-sensitive diagnostic reforms.In conclusion, the commentary calls for equitable mental health care frameworks that recognize diverse depressive manifestations across genders. Addressing these biases through gender-sensitive practices and diagnostic adjustments can bridge disparities, reduce over- or under-treatment, and foster inclusivity in mental health care systems, ensuring better outcomes for all individuals.
这篇评论探讨了抑郁症诊断和治疗中性别偏见这一关键问题,回应了巴西加卢佩等人[3]的研究,该研究强调了老年人心理健康护理方面的差异。在认可该研究优点的同时,评论主张对系统性偏见和性别化症状进行更深入的探究。女性频繁的医疗互动增加了她们被诊断和治疗的可能性,而男性不愿寻求帮助往往导致诊断延迟或漏诊,男性典型的外化症状如攻击性、冒险行为和药物滥用使情况更加复杂。植根于典型内化症状的传统诊断工具和标准未能充分捕捉这些男性典型表现。评论还强调了传统男性气质观念(TMI)在塑造男性心理健康行为方面的作用。这些社会建构的规范促进情绪抑制和自力更生,加剧性别角色冲突、功能失调和差异压力,从而减少求助行为。高度符合TMI与较差的治疗效果、较高的辍学率和较低的治疗疗效相关。评论批评了在过度医学化女性心理健康的同时忽视男性痛苦表现的双重偏见,主张进行对性别敏感的诊断改革。总之,评论呼吁建立公平的心理健康护理框架,承认不同性别的各种抑郁表现。通过对性别敏感的做法和诊断调整来解决这些偏见,可以弥合差距,减少过度治疗或治疗不足,并在心理健康护理系统中促进包容性,确保所有人都能获得更好的结果。