Should gender be considered in the identification
and treatment of psychiatric disorders? Yes, at least in the case of
common psychiatric illness that affects 10% to 20% of the population. Depression
disproportionately, more commonly than men. Women are more likely
than men to be diagnosed, and depression in women may manifest earlier. Episodes of depression may be more severe in women; an increased number of suicide
has been observed in affected women.
osteoporosis, and autoimmune conditions top the list of ailments well known for
their gender bias. Clinicians pay due attention to the gender variations that
these conditions show while selecting the treatment modalities. Recent
evidences demand the inclusion of psychiatric ailments to the list.
The manifestation of psychiatric disorders such as major depressive
disorder (MDD) is not identical in men and women. Women may be more prone to atypical symptoms of depression
suggests the STAR*D study. Even the response to treatment varies; while men may
favour tricyclic antidepressants
women show robust response to selective serotonin reuptake inhibitors.
The absorption and distribution of drugs in the
body also differs because women have a higher percentage of adipose tissue than
men. Women secrete less gastric acid and exhibit decreased gastric motility and
emptying times. Differences have also been noted in enzymatic activities that
could affect the concentration of medication. Variation
in side-effect profile of drugs also warrants increased level of alertness from
clinicians; women are at a high risk of osteoporosis
The exact cause of the disparity in depression
genders is not clear. It is possibly an interplay of multiple factors that
include hormonal and
neurobiological variables, as well as social and behavioural factors.
Women and Depression: Does Gender Matter?; Thomas
Smith et al; US Pharmacist 2013