Gender, Life Events, and Depression: An Exploratory Study

CONTEXT Literature is inconsistent about the role of gender in mediating the relationship between life events and depression. AIM Our objective was to explore gender differences in patterns and frequencies of stressful life events before onset of a depressive episode. SETTING AND DESIGN Cross-sectional study at a tertiary care center. SUBJECTS AND METHODS One hundred patients fulfilling Diagnostic and Statistical Manual of Mental Disorders fourth edition criteria for current major depression (50 males and 50 females) were recruited for the study. Structured instruments were used to assess psychiatric comorbidity, episode severity, and stressful life events. We compared the number and frequency of stressful life events between genders and their relationship with demographic and clinical variables. STATISTICAL ANALYSIS USED Mann-Whitney U-test and Chi-square test. RESULTS Women with depression were older, more likely to be married (P < 0.01), had lower rates of comorbid panic disorder (P < 0.01) and nicotine dependence (P = 0.016) compared to men. Total stress scores and median number of stressful events in the year before onset of depression were significantly lower in women (P < 0.01). Getting married, job or property-related stressors, and breakup of friendship were more commonly reported stressors among males while more females reported dowry-related issues before symptom onset. In stratified analysis, these gender differences continued to hold good only in those with comorbid dysthymia. CONCLUSION There appears to be a sex-specific effect of certain life events on depression. Comorbid dysthymia may play an important role in mediating this differential stress sensitivity across genders.