Current Psychiatry Reports

, Volume 8, Issue 2, pp 108–114 | Cite as

Depression in children and adolescents: Does gender make a difference?

  • Elizabeth B. Weller
  • Angelica Kloos
  • Joon Kang
  • Ronald A. Weller


The occurrence of depression is higher in females after puberty, suggesting a gender-related difference. This article reviews studies that have examined gender differences in the presentation and treatment of depression in adults and discusses how this information applies to depressed children and adolescents. The adult literature suggests that men and women vary in presentation of depression. In addition, differences exist in the pharmacokinetic properties of various medications, but it is unclear how they affect clinical treatment response. Studies of gender differences in child and adolescent depression are limited. Some studies suggest that differences seen in adults may also apply to children and adolescents. Studies of gender differences in treatment response are not available, however. Further study and evidence-based exploration are required to better understand gender differences in depression in children and adolescents.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Birmaher B, Brent DA, Benson RS: Child and adolescent depression: A review of the past ten years. Part I. J Am Acad Child Adolesc Psychiatry 1996, 35:1427–1439.PubMedCrossRefGoogle Scholar
  2. 2.
    Keller MB, Silverman M, Awakuni G, et al.: Safeguarding your students against suicide: a report from the National Mental Health Association. report.pdf. Accessed October 24, 2005.Google Scholar
  3. 3.
    Kovacs M: Presentation and course of major depressive disorder during childhood and later years of the life span. J Am Acad Child Adolesc Psychiatry 1996, 35:705–715.PubMedCrossRefGoogle Scholar
  4. 4.
    Fergusson DM, Woodward LJ: Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry 2002, 59:225–231.PubMedCrossRefGoogle Scholar
  5. 5.
    Lewinsohn PM, Clarke GN, Seeley JR, Rhodes P: Major depression in community adolescents: age at onset, episode duration, and time to recurrence. J Am Acad Child Adolesc Psychiatry 1994, 33:809–818.PubMedCrossRefGoogle Scholar
  6. 6.
    Weissman MM, Bland RC, Canino GJ, et al.: Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996, 276:293–299.PubMedCrossRefGoogle Scholar
  7. 7.
    Hankin BL, Abramson LY, Moffitt TE, et al.: Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. J Abnorm Psychol 1998, 107:128–140.PubMedCrossRefGoogle Scholar
  8. 8.
    Kuehner C: Gender differences in the short-term course of unipolar depression in a follow-up sample of depressed inpatients. J Affect Disord 1999, 56:127–139.PubMedCrossRefGoogle Scholar
  9. 9.
    Kornstein SG: Gender differences in depression: implications for treatment. J Clin Psychiatry 1997, 58(Suppl 3):S12–18.Google Scholar
  10. 10.
    McCauley E, Myers K, Mitchell J, et al.: Depression in young people: initial presentation and clinical course. J Am Acad Child Adolesc Psychiatry 1993, 32:714–722.PubMedCrossRefGoogle Scholar
  11. 11.
    Reinecke MA, Simons A: Vulnerability to depression among adolescents: implications for cognitive-behavioral treatment. Cogn Behav Pract 2005, 12:166–176.CrossRefGoogle Scholar
  12. 12. Depression in women: what every woman should know. Depression/nimh/people_women.asp. Accessed October 24, 2005.Google Scholar
  13. 13.
    Williams JB, Spitzer RL, Linzer M, et al.: Gender differences in depression in primary care. Am J Obstet Gynecol 1995, 173:654–659.PubMedCrossRefGoogle Scholar
  14. 14.
    Frank E, Carpenter LL, Kupfer DJ: Sex differences in recurrent depression: Are there any that are signi.cant? Am J Psychiatry 1988, 145:41–45.PubMedGoogle Scholar
  15. 15.
    Scheibe S, Preuschhof C, Cristi C, Bagby RM: Are there gender differences in major depression and its response to antidepressants? J Affect Disord 2003, 75:223–235.PubMedCrossRefGoogle Scholar
  16. 16.
    Carter JD, Joyce PR, Mulder RT, et al.: Gender differences in the presentation of depressed outpatients: A comparison of descriptive variables. J Affect Disord 2000, 61:59–67.PubMedCrossRefGoogle Scholar
  17. 17.
    Frackiewicz EJ, Sramek JJ, Cutler NR: Gender differences in depression and antidepressant pharmacokinetics and adverse events. Ann Pharmacother 2000, 34:80–88.PubMedCrossRefGoogle Scholar
  18. 18.
    Angst J, Dobler-Mikola A: Do the diagnostic criteria determine the sex ratio in depression? J Affect Disord 1984, 7:189–198.PubMedCrossRefGoogle Scholar
  19. 19.
    Simon RW: Revisiting the relationship among gender, marital status, and mental health. Am J Sociol 2002, 107:1065–1096.PubMedCrossRefGoogle Scholar
  20. 20.
    Winkler D, Pjrek E, Heiden A: Gender differences in the psychopathology of depressed inpatients. Eur Arch Psychiatry Clin Neurosci 2004, 254:209–214.PubMedGoogle Scholar
  21. 21.
    Kornstein SG, Schatzberg AF, Thase ME, et al.: Gender differences in chronic major and double depression. J Affect Disord 2000, 60:1–11.PubMedCrossRefGoogle Scholar
  22. 22.
    Sloan DM, Kornstein SG: Gender differences in depression and response to antidepressant treatment. Psychiatr Clin N Am 2003, 26:581–594.CrossRefGoogle Scholar
  23. 23.
    Cuffe S, Waller J, Cuccaro M: Race and gender differences in the treatment of psychiatric disorders in young adolescents. J Am Acad Child Adolesc Psychiatry 1995, 34:1536–1543.PubMedCrossRefGoogle Scholar
  24. 24.
    Obeidallah DA, McHale SM, Silbereisen RK: Gender role socialization and adolescents’ reports of depression: Why some girls and not others? J Youth Adolesc 1996, 25:775–785.CrossRefGoogle Scholar
  25. 25.
    Bennett DS, Ambrosini PJ, Kudes D, et al.: Gender differences in adolescent depression: Do symptoms differ for boys and girls? J Affect Disord 2005, 89:35–44.PubMedCrossRefGoogle Scholar
  26. 26.
    Frank E, Young E: Pubertal changes and adolescent challenges: Why do rates of depression rise precipitously for girls between the ages 10 to 15 years? In Gender and its Effects on Psychopathology. Edited by Frank E. Washington, DC: American Psychiatric Publishing; 2000.Google Scholar
  27. 27.
    Hankin BL, Abramson L: Development of gender differences in depression: description and possible explanations. Ann Med 1999, 31:372–379.PubMedCrossRefGoogle Scholar
  28. 28.
    Bebbington PE, Dunn G, Jenkins R, et al.: The in.uence of age and sex on the prevalence of depressive conditions: report from the National Survey of Psychiatric Morbidity. Psychol Med 1998, 328:9–19.CrossRefGoogle Scholar
  29. 29.
    Hay AG, Bancroft J, Johnson EC: Affective symptoms in women attending a menopause clinic. Br J Psychiatry 1994, 164:513–516.PubMedGoogle Scholar
  30. 30.
    Parry BL: Zeproductive factors affecting the course of affective illness. Psychiatr Clin North Am 1989, 12:207–220.PubMedGoogle Scholar
  31. 31.
    Endicott J: The menstrual cycle and mood disorders. J Affect Disord 1993, 29:193–200.PubMedCrossRefGoogle Scholar
  32. 32.
    Stroud LR, Papandonatos GD, Williamson DE, Dahl RE: Sex differences in the effects of pubertal development on responses to a corticotropin-releasing hormone challenge. Ann N Y Acad Sci 2004, 1021:348–351.PubMedCrossRefGoogle Scholar
  33. 33.
    Bierut LJ, Heath AC, Bucholz KK, et al.: Major depressive disorder in a community-based twin sample: are there different genetic and environmental contributions for men and women? Arch Gen Psychiatry 1999, 56:557–563.PubMedCrossRefGoogle Scholar
  34. 34.
    Beck AT: Cognitive therapy of depression: New perspectives. In Treatment of Depression: Old Controversies and New Approaches. Edited by Clayton PJ, Barrett JE. New York: Raven Press; 1983:265–290.Google Scholar
  35. 35.
    Calvete E, Cardenoso O: Gender differences in cognitive vulnerability to depression and behavior problems in adolescents. J Abnorm Child Psychol 2005, 33:179–192. s study explores the gender differences in cognitive variables leading to depression in children and adolescents. The suggestions the authors make for explaining the cognitive factors leading to depression are essential to understanding gender differences in presentation and phenomenology of adolescent depression.PubMedCrossRefGoogle Scholar
  36. 36.
    Ahnlund K, Frodi A: Gender differences in the development of depression. Scand J Psychology 1996, 37:229–237.Google Scholar
  37. 37.
    Nolen-Hoeksema S, Larson J, and Grayson C: Explaining the gender difference in depressive symptoms. J Pers Soc Psychol 1999, 77:1061–1072.PubMedCrossRefGoogle Scholar
  38. 38.
    Cyranowski J, Frank E, Young E, Shear K: Adolescent onset of the gender difference in lifetime rates of major depression. Arch Gen Psychiatry 2000, 57:21–27.PubMedCrossRefGoogle Scholar
  39. 39.
    Sands T, Howard-Hamilton M: Understanding depression among gifted adolescent females: Feminist therapy strategies. Roeper Review 1995, 17:192–196.Google Scholar
  40. 40.
    Hayward C, Gotlib I, Schraedley P, Litt I: Ethnic differences in the association between pubertal status and symptoms of depression in adolescent girls. J Adolesc Health 1999, 25:143–149.PubMedCrossRefGoogle Scholar
  41. 41.
    US Department of Health and Human Services: The National Women’s Health Indicators Database. http:// Accessed December 15, 2005.Google Scholar
  42. 42.
    Logsdon MC: Depression in adolescent girls: screening and treatment strategies for primary care providers. J Am Med Women Assoc 2004, 59:101–106.Google Scholar
  43. 43.
    Hamilton JA, Grant M, Jensvold MF: Sex and treatment of depressions: when does it matter? In Psychopharmacology and Women: Sex, Gender and Hormones. Edited by Jensvold MF, Halbreich U, Hamilton JA. Washington, DC: American Psychiatric Press; 1996:241–260.Google Scholar
  44. 44.
    Gex-Fabry M, Balant-Gorgia AE, Balant LP, Garrone G: Clomipramine metabolism: model-based analysis of variable factors from drug monitoring data. Clin Pharmacokinet 1990, 19:241–255.PubMedCrossRefGoogle Scholar
  45. 45.
    Kornstein SG, Schatzberg AF, Thase ME, et al.: Gender differences in treatment response to sertraline versus imipramine in chronic depression. Am J Psychiatry 2000, 157:1445–1452.PubMedCrossRefGoogle Scholar
  46. 46.
    Quitkin FM, Stewart JW, McGrath PJ: Gender differences in treatment response [letter]. Am J Psychiatry 2001, 158:1531–1532.PubMedCrossRefGoogle Scholar
  47. 47.
    Soares CN, Poitras JR, Prouty J, et al.: Efficacy of citalopram as a monotherapy or as an adjunctive treatment to estrogen therapy for perimenopausal and postmenopausal women with depressive and vasomotor symptoms. J Clin Psych 2003, 64:473–479.CrossRefGoogle Scholar
  48. 48.
    Pearlstein TB: Hormones and depression: What are the facts about premenstrual syndrome, menopause, and hormone replacement therapy? Am J Obstet Gynecol 1995, 173:646–653.PubMedCrossRefGoogle Scholar
  49. 49.
    Yonkers KA, Kando JC, Cole JO, Blumenthal S: Gender differences in pharmacokinetics and pharmacodynamics of psychotropic medication. Am J Psychiatry 1992, 149:587–595.PubMedGoogle Scholar
  50. 50.
    Martenyi F, Dossenbach M, Mraz K, Metcalfe S: Gender differences in the efficacy of fluoxetine and maprotiline in depressed patients: a double-blind trial of antidepressants with serotonergic or norepinephrinergic reuptake inhibition pro.le. Eur Neuropsychopharmacol 2001, 11:227–232.PubMedCrossRefGoogle Scholar
  51. 51.
    Baca E, Garcia-Garcia M, Porras-Chavarino A: Gender differences in treatment response to sertraline versus imipramine in patients with nonmelancholic depressive disorders. Prog Neuropsychopharmacol Biol Psychiatry 2004, 28:57–65.PubMedCrossRefGoogle Scholar
  52. 52.
    Hildebrandt MG, Steyerberg EW, Stage KB, et al.: Are gender differences important for the clinical effects of antidepressants? Am J Psychiatry 2003, 160:1643–1650.PubMedCrossRefGoogle Scholar
  53. 53.
    Thiels C, Linden M, Grieger F, Leonard J: Gender differences in routine treatment of depressed outpatients with the selective serotonin reuptake inhibitor sertraline. Int Clin Psychopharmacol 2005, 20:1–7.PubMedCrossRefGoogle Scholar
  54. 54.
    Quitkin FM, Stewart JW, McGrath PJ, et al.: Are there differences between women’s and men’s antidepressant responses? Am J Psychiatry 2002, 159:1848–1854. Though this study focuses on adult literature, this meta-analysis is an excellent review of recent studies exploring gender effects on depression treatment.PubMedCrossRefGoogle Scholar
  55. 55.
    Labellarte M, Biederman J, Emslie G, et al.: Multipledose pharmacokinetics of fluvoxamine in children and adolescents. J Am Acad Child Adolesc Psychiatry 2004, 43:1497–1505.PubMedCrossRefGoogle Scholar
  56. 56.
    Tosyali MC, Greenhill LL: Child and adolescent psychopharmacology. Important developmental issues. Pediatr Clin North Am 1998, 45:1021–1035.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc. 2006

Authors and Affiliations

  • Elizabeth B. Weller
  • Angelica Kloos
    • 1
  • Joon Kang
  • Ronald A. Weller
  1. 1.Department of PsychiatryThomas Jefferson University HospitalPhiladelphiaUSA

Personalised recommendations