Sex-related effects in major depressive disorder: Results of the European Group for the Study of Resistant Depression

Depression and AnxietyBartova L, Dold M, Fugger G, et al. | June 11, 2021

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Previous works describe gender-related effects on the evolution and phenotype of major depressive disorder (MDD). Researchers conducted this European multicenter cross-sectional study comparing sociodemographic, clinical, and treatment patterns between males and females in a real-world sample of 1,410 in- and outpatients with current MDD. Findings revealed that relative to females, male MDD patients more frequently received treatment as inpatients, suffered from moderate to high suicidality levels, received noradrenergic and specific serotonergic antidepressants (NaSSAs) as first-line antidepressant (AD) treatment, and generally higher mean daily doses of the administered ADs. In addition, males had a trend towards a more frequent administration of add-on treatments. Female MDD patients rather received treatment as outpatients and experienced low suicidality levels, comorbid thyroid dysfunction, migraine, and asthma when compared with males. Females showed a trend towards earlier mean age of MDD onset. These divergences may serve as predictors of disease severity and course, as they reflect phenomena that were repeatedly linked to treatment-resistant depression (TRD). Based on findings, they suggest that gender consideration may guide the diagnostic and therapeutic processes towards targeting challenging clinical manifestations including comorbidities and suicidality, and prevention of TRD and chronicity.

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