Cross-national associations between gender and mental disorders in the WHO World Mental Health Surveys

By S. Seedat, K. Scott, M. Angermeyer, P. Berglund, E. Bromet, T. Brugha, K. Demyttenaere, G. de Girolamo, Josep Maria Haro, R. Jin and 11 more. Archives of General Psychiatry, 2009

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Context Gender differences in mental disorders, including more anxiety-mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The “gender roles” hypothesis suggests that these differences should narrow as the roles of women and men become more equal. Objective To study time-space (i.e., cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the WHO World Mental Health (WMH) Survey Initiative and determine if this variation is significantly related to time-space variation in female gender role traditionality (GRT) as measured by aggregate patterns of female education, employment, marital timing, and use of birth control. Design/Setting and Participants Face-to face household surveys of 72,933 community-dwelling adults in Africa, the Americas, Asia, Europe, the Middle East, and the Pacific. Main Outcomes The WHO Composite International Diagnostic Interview (CIDI) assessed lifetime prevalence and age-of-onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in Female:Male (F:M) odds-ratios (ORs) of these disorders across cohorts defined by age ranges 18–34, 35–49, 50–64, and 65+. Structural equation analysis examined predictive effects of variation in GRT on these ORs. Results Women had more anxiety-mood disorders than men and men more externalizing-substance disorders than women in all cohorts and countries. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder (MDD) and substance disorders. This narrowing was significantly related to temporal (MDD) and spatial (substance disorders) variation in GRT. Conclusion While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied, substantial inter-cohort narrowing of differences in major depression was found related to changes in the traditionality of female gender roles. Further research is needed to understand why this temporal narrowing was confined to major depression.

Subfields: Experimental and Cognitive Psychology, Public Health, Environmental and Occupational Health, Social Psychology

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Citations in the corpus

• The social determinants of mental health and disorder: evidence, prevention and recommendations (2024, background): “For example, depression and anxiety are ap­ proximately twice as common in women than men 197 , a pattern that seems reversed in non­affective psychotic disorders (although this is most pronounced for first onset in early adulthood) 198 .”
• Does psychopathy manifest divergent relations with components of its nomological network depending on gender (2011, background): “This is to be expected as males have higher rates of most externalizing forms of psychopathology (e.g., Seedat et al., 2009) and score lower on the trait of Agreeableness (see Costa, Terracciano, & McCrae, 2001), which is a core trait of psychopathy (Lynam & Derefinko, 2006).”
• Stress and depression: old questions, new approaches (2015, background): “Demographic factors, such as female gender, younger (rather than old) age, and lower socioeconomic status predict higher rates of depressive disorders and symptoms [29,30] in part because they are associated with acute and chronic stressors.”
• Guidelines for the Prevention of Stroke in Women: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association (2014, background): “Women have higher rates of depression, and thus, these factors may be of greater impact for women.(446)”
• Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature (2012, background): “The average duration of an episode estimated from WMHS ranged from 23.1 to 33.8 weeks (Kessler & Üstün, 2008 ; Seedat et al. 2009 ; Bromet et al. 2011).”