Gender difference and phenomenology of unipolar depression from Indian perspective

Abstract

Gender differences are diverse between studies of unipolar and bipolar depressive disorders. Thus gender difference reported so far in depression studies might have confounded from their level of intrinsic bipolarity. The objectives of this study were to test whether there were any gender differences in the phenomenology of unipolar Major Depressive Disorder (MDD) and whether any phenomenology reliably predicted the gender of Indian patients. Patients with the diagnosis of unipolar MDD, between 18 and 60 years of age were included. A total of 32 males and 36 females were assessed with the diagnostic criteria of DSM-IV-TR, the Hamilton Depression Rating Scale, the Beck Depression Inventory-II and the Global Assessment of Functioning. Females in our study were significantly more likely to be married (p = 0.008), unemployed (p = 0.000), with lower educational qualification (p = 0.009) and belong to a lower-socioeconomical class (p = 0.003). Males had a younger age at the onset of MDD (p = 0.004) and more recurrence (p = 0.030), loss of pleasure (melancholic feature) (p = 0.030) and perceived functional impairment (p = 0.041). In females, significant greater frequency of recurrent thoughts of death (p = 0.000), perceived sense of failure (p = 0.014) and social withdrawal (p = 0.041) were found. Recurrent thoughts of death was the only phenomenon that reliably predicted gender. The uniqueness of our findings could be attributed to relatively purer unipolarity of participants and recent changes in social and individual perspectives in rapidly developing world.

Keywords:

• unipolar depression
• bipolarity
• gender difference
• phenomenology
• suicide

Acknowledgements

We acknowledge Ms. Devosri Sen, PhD Scholar in the Department of Psychology, Central Institute of Psychiatry, Ranchi, India, for her contribution to the manuscript write-up.

Notes on contributors

Partha Sarathi Biswas is a Senior Resident (Psychiatry) since 2010, at the Department of Psychiatry, Ranchi Institute of Neuro-Psychiatry and Allied Sciences (RINPAS), Kanke, Ranchi, India. He is also an Hon. Editor of Indian Journal of Psychiatry-Jharkhand State Branch and served as an Editorial Consultant of RINPAS journal (ISSN 2231-2811) in 2011–2012. His areas of interest are depression, organic psychiatry, epilepsy and behavior, personality disorder, and culture and mental health. He has teaching and research experience and has published in major international journals.

C.R.J. Khess is a Professor (Psychiatry) and Head of the De-addiction Centre, Central Institute of Psychiatry (C.I.P), Kanke, Ranchi, India. His areas of interest are bipolar affective disorder, obsessive compulsive disorder, substance dependence and related disorders. He has published papers in many national and international journals.