Risk for mental illness varies by gender

Women are more likely to be diagnosed with depression and anxiety, while men are at greater risk for substance abuse and antisocial disorders, according to a new study examining gender differences in rates of mental illnesses.

The gender differences may be related to how the sexes deal with their emotions. Women are more likely to internalize their emotions and withdraw, leading to depression and anxiety. Men, however, are more likely to externalize their emotions and act out.

"It is not that major depression itself is significantly higher in women than in men; rather, our study suggests that internalizing [behavior] is higher in women than in men, and this difference is manifested in gender differences in a variety of mental disorder prevalence rates," says study author Nicholas R. Eaton, MA, a psychologist at the University of Minnesota in Minneapolis.

The new findings, which appear in the Journal of Abnormal Psychology, may have important implications for the prevention and treatment of mental illness in women and men.

For example, coping skills and cognitive behavior therapy aimed at reducing over-thinking may help prevent full-blown depression or anxiety among at-risk women.

Eaton and colleagues analyzed data on more than 43,000 people who took part in the National Epidemiologic Survey on Alcohol and Related Conditions. Participants were interviewed about their lifetime history of mental illness, including information on any diagnosis made in the previous year. Women were more likely to be diagnosed with depression and anxiety, while men were more likely to be diagnosed with substance abuse and antisocial disorders.

Specifically, 22% of women had been diagnosed with depression during their lifetime, compared with 13.1% of men. By contrast, 17.4% of men had a lifetime history of alcohol dependence, compared with 8% of women in the study.

"Efforts focusing solely on prevention, diagnosis, and treatment of specific mental disorders misses an important part of the picture," Eaton says in an email. The new findings provide new ways of predicting future mental health, he says.

Depression Hits Men, Too

The new findings make sense to Philip D. Harvey, PhD, a professor of psychiatry and behavioral sciences at the University of Miami Miller School of Medicine in Florida.

"We do see more anxiety and depression in women and more psychosis and antisocial behavior in men," he says.

This is the rule, but there are exceptions, he says. "Yes, there are gender differences, but there is no such thing as gender exclusivity," he says.

Men can have depression or anxiety disorders and should not be discouraged from seeking treatment, he says.

Understanding gender differences is a big issue in all areas of medicine today, including psychiatry, he says. The National Institutes of Health will only fund grants that include women and minorities and also encourages that the findings be analyzed by gender.