ABSTRACT

Sex differences in the prevalence of common affective disorders have been well documented in most Western populations. For example, the American National Comorbidity Survey based on a nationwide probability sampling frame of 8,000 men and women found a female preponderance of 1.7 for lifetime DSM-III-R Major Depressive Disorder and the British National Survey of Psychiatric Morbidity found a female excess of 1.5 for depression and 1.8 for mixed states of depression and anxiety. The excess is most marked during the reproductive years, emerging at adolescence and peaking in the mid-30s. In prepubertal children there is a male preponderance of depression, the female excess emerging during adolescence. The female excess, particularly for milder disorders, is greatest in early adulthood and subsequently declines. Whether it ever disappears entirely is debatable, with some studies showing a persistent elevation and others finding a male excess in late life.