One of the most consistent findings in the whole of psychiatric epidemiology is that women are more likely to suffer from depression than men. Thus, in the summary of the DIS studies (Weissman et al., 1996), the sex ratio for the lifetime prevalence of depression ranged from 1.6 to 3.0. The two British national surveys gave a sex ratio for 1-week prevalence on the low side, at 1.5 and 1.2, respectively. The Finnish national study gave a value of 1.5 (Lindeman et al., 2000). There have been numerous reviews (Bebbington, 1996; Maier et al., 1999; Merikangas, 2000; Piccinelli & Wilkinson, 2000). The very large, six-nation European study DEPRES (Depressive Research in European Society) (Angst et al., 2002) establishes the sex difference at the level both of MDD (F:M = 1.7) and of the various depressive symptoms. Very few studies have shown ratios close to unity, and they have usually been in restricted populations.
This consistency of the sex ratio is not matched by any clarity of explanation. Before considering the possible causes, we must consider the influence of age on depression.
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