Gender differences in the prevalence of depressive disorders

Spolne razlike imaju bitnu ulogu u pojavnosti, kliničkoj slici i liječenju mnogih psihičkih i tjelesnih bolesti i poremećaja. Među psihičkim poremećajima, ta se različitost posebno jasno vidi u depresivnm poremećaju. Žene, neovisno o etničkoj i nacionalnoj pripadnosti, imaju statistički dva puta veću pojavnost depresije od muškarca. Nadalje kod muškaraca se depresija često previdi i rjeđe dijagnosticira. Spolne razlike u prevalenciji depresivnih epizoda naročito su vidljive od puberteta pa do predmenopauzalnog perioda, korespondirajući s generativnim životnim razdobljem žene. Najveća incidencija se javlja tijekom fertilne dobi, što se tumači cikličkim djelovanjem hormona. Postoje četiri tipa depresivnog poremećaja vezanih uz cikličko djelovanje hormona, specifična za reproduktivno razdoblje žene: predmenstrualni disforični poremećaj, depresija u trudnoći, postpartalna depresija i depresivni poremećaj u menopauzi. Klinički izražaj simptoma druga je važna različitost depresije u žena i muškaraca koja se očituje u tome što žene u većoj mjeri imaju prisutan i neki prateći poremećaj, najčešće anksiozni poremećaj i poremećaje hranjenja, a muškarci pate od različitih tipova ovisnosti. Žene često imaju atipične simptome poput porasta apetita i tjelesne težine, dok muškarci češće pokazuju tipične neurovegetativne simptome poput insomnije i gubitka težine. Žene također drugačije percipiraju i izražavaju emocije, a time i svoje simptome, te imaju snažniji subjektivni doživljaj težine svojih simptoma. Također, žene češće pokušavaju suicid, no muškarci ga češće i dovršavaju, birajući pri tom drugačija sredstva. Razlike s obzirom na spol postoje i ovisno o antidepresivnoj terapiji, što se nastoji tumačiti razlikama u farmakokinetici i utjecaju hormona. Zaključno, pri dijagnosticiranju, liječenju i praćenju bolesnika oboljelih od depresije, nužno je uzeti u obzir i spolne razlike.Gender differences play a key role in the occurrence of depressive disorders. Women, regardless of ethnical or national belonging, are statistically two times more prone to suffer from depression, with men depression is often predicted, but rarely diagnosed. Sexual differences in the prevalence of depressive episodes are seen in early puberty (around 10 years) and last until middle age, characteristically corresponding with the generative life span of women, with the greatest incident rate during the fertile period, what is likely due to the cyclical functioning of the hormones. There are four types of disorders linked to the cyclical functioning of the hormones specific for women’s reproductive period: premenstrual disphoric disorder, depression during pregnancy, postpartal depression and the depressive disorder during menopause. The clinical expression of symptoms is the second most important difference between male and female depression, which is seen in the fact that women frequently have an accompanying disorder, most often an anxiety disorder or an eating disorder, while men suffer from different types of addiction. Women often have atypical symptoms such as an increase in appetite and body weight, while men frequently show typical neurovegetative symptoms such as insomnia and the loss of weight. Women also perceive and express emotions differently and with it their symptoms, and they have a more powerful subjective experience regarding the significance of their symptoms. Women also attempt suicide more frequently, while men commit it more frequently, both choosing different means to do so. Differences regarding gender also exist depending on the antidepressant therapy, which is likely due to the differences in pharmacokinetics and their influence on hormones. Finally it is necessary to take into account gender differences regarding diagnosis, treatment and the observation of patients suffering from depression