Gender Differences and Psychiatric Disorders

Psychiatric Times

January 2005

Vol. XXII

Issue 1

Gender is an important variable in medicine and psychiatry, and has been increasingly recognized in clinical work and research. The terms gender and gender role came into use since the pioneering work of Money and Stoller in the l950s and l960s to distinguish between the anatomical and biological characteristics of sex and the more complex concepts that include social stereotypes and expectations and their variations in different cultures. These terms reflect the fact that what one considers masculine and feminine is heavily determined by psychosocial and developmental factors. Women have different life experiences than men growing up. Biological interact with psychosocial factors in a reciprocal way, and these may be difficult to sort out.

There are gender differences in the incidence of psychiatric disorders. Among the most prominent of these is the higher incidence of depression in women. Impulsive and violent behavior is more prevalent in men. There are different theories as to why these differences occur, and the reason for these differences is not entirely clear. Hormonal factors have been studied and are not considered to be sufficient.

The onset of depression in women appears to be early, around the beginning of adolescence. This has been explained as coinciding with the girl's entry into the stereotypical conventional female adult role, with its vulnerabilities and social pressures. Midlife, although having stresses of its own--marital strains, aging parents, assessment of successes and failures, and the awareness of mortality--is nevertheless not a period of high incidence of depression. Perimenopausal depression, although the subject of considerable recent research, is not prominent and does not appear to be inevitable. The perimenopausal period may, in fact, be accompanied by relief.

The increased interest in gender issues, stimulated by the women's movement and the recognition that women had been absent from much research, gave rise to numerous biological and psychosocial studies and a growth of the literature. The field has expanded to include more specific and sensitive attention to men and the role of gender and gender differences.

The papers presented in this issue of Psychiatric Times contribute to the growing research data in this area.

Dr. Notman is professor of psychiatry at Harvard University and a member of the PT Editorial Board.