Gender Difference in the Prevalence of Clinical Depression: The Role Played by Depression Associated With Somatic Symptoms

OBJECTIVE: This study tested the hypothesis that female subjects may exhibit a higher prevalence than male subjects of depression associated with somatic symptoms but not a higher prevalence of depression not associated with these other symptoms. METHOD: The author reanalyzed research interview data on major depression from the National Comorbidity Survey, dividing respondents into those who met overall criteria for major depression and exhibited fatigue and appetite and sleep disturbance (“somatic depression”) and those who met overall criteria but did not exhibit these somatic criteria (“pure depression”). RESULTS: Female subjects exhibited a higher prevalence than male subjects of somatic depression but not a higher prevalence of pure depression. Somatic depression was associated with a high prevalence of anxiety disorder and, among female subjects, with body aches and onset of depression during early adolescence. CONCLUSIONS: The gender difference in depression may result from a difference in a specific subtype of anxious somatic depression. (Am J Psychiatry 1999; 156:480–482)