Understanding Sex Differences in Mental Illness and Its Impact
Exploring various aspects of mental health issues, this content sheds light on sex differences in depression, anxiety disorders, PTSD, and suicide rates. It discusses the age of onset for depression, the prevalence of anxiety disorders, and the challenges individuals face in dealing with mental illness. The content also touches upon the role of biology in mental health and the traumatic effects of PTSD based on sexual orientation and experiences such as rape.
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Sex Differences in Mental Illness D. Jeffrey Newport, MD, MS, MDiv Director, Women s Reproductive Mental Health Professor of Psychiatry & Behavioral Sciences and Obstetrics & Gynecology University of Miami Miller School of Medicine
Percentage of Adults with Depression Percentage of Adults with Depression National Health & Nutrition Examination Survey: 2013-16 14 12 10 8 6 4 2 0 All Ages 20 - 39 40 - 59 60 & Over Men Women NCHS Data Brief No. 303, February 2018
3 Age at Onset Of Depression: Sex Differences United States ECA Males Females 4.0 3.5 3.0 Rate Per 100 2.5 2.0 1.5 1.0 0.5 0.0 0-14 15-24 25-34 35-44 45-54 55-64 Age At First Onset (years) Weissman et al. JAMA 1996; 276: 293
Percentage of Depressed Adults Reporting Difficulty Percentage of Depressed Adults Reporting Difficulty with Work, Home, or Social Activities with Work, Home, or Social Activities National Health & Nutrition Examination Survey: 2013-16 60 50 40 30 20 10 0 No Difficulty Some Difficulty Moderate to Extreme Difficulty Men Women NCHS Data Brief No. 303, February 2018
Suicide Rates by Sex Suicide Rates by Sex United States 2006-2016 25 20 15 10 5 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Men Women NCHS, National Vital Statistics System, Mortality
Anxiety Disorders: Prevalence and Sex Differences Anxiety Disorders: Prevalence and Sex Differences Generalized Anxiety Disorder Social Anxiety Disorder Panic Disorder Overall Prevalence 3.1% 2.7% 6.8% Prevalence by Sex Women 2x > Men Women 2x > Men Women = Men Obsessive- Compulsive Disorder Specific Phobias PTSD Overall Prevalence 8.7% 1.0% 3.5% Prevalence by Sex Women 2x > Men Women = Men Women > Men* Anxiety & Depression Association of America
8 PTSD & Trauma Prevalence: Sex & Sexual Orientation *Rape is most likely trigger. 65% of men and 46% of women who are raped develop PTSD. Roberts AL (2010) Am J Public Health 100(12):2433-41
9 Postpartum Mood Disturbance 60 50 40 30 20 10 POSTPARTUM BLUES 50%-70% within 10-14 days transient, considered nonpathologic POSTPARTUM DEPRESSION (PPD) 10-20% of adult women 2/3 have onset by 6 weeks postpartum serious and disabling POSTPARTUM PSYCHOSIS (PPS) 1-2/1000 live births 70% are affective (bipolar, depression) Psychiatric emergency Psychiatric Admissions Per Month Pregnancy -2 Years -1 Year Childbirth +1 Yr +2 Years 50 40 30 20 10 Psychosis Admissions Per Month Pregnancy -2 Years -1 Year +2 Years Childbirth +1 Yr Kendell RE et al. Br J Psychiatry 1987; 150: 662-73 Newport et al. J Clin Psychiatry 2002; 63(suppl 7): 31.
Interpersonal Therapy for Postpartum Depression Role Transitions / Role Conflict Problem: new roles increased demands lower self-esteem 10 Goal:combine new roles with those already established Example Working Mother Potential to be overwhelmed Exacerbated by partner and/or employer being resistant to change Solution: develop balanced view of her needs & determine expectations of partner & employer Develop problem focus and potential solutions (actual solution less important than teaching patient to assess her relationships and empowering her to enact change) Increase partner s role in childcare Decrease time spent at work More flexible work hours Alternative child care Stuart S, O Hara MW. J Psychother Pract Res 1995; 4: 18-29
