 |
|
Cross-National Associations Between Gender and Mental Disorders in the World Health Organization World Mental Health Surveys
Soraya Seedat, PhD;
Kate Margaret Scott, PhD;
Matthias C. Angermeyer, PhD;
Patricia Berglund, MBA;
Evelyn J. Bromet, PhD;
Traolach S. Brugha, MD (NUI), FRCPsych;
Koen Demyttenaere, MD, PhD;
Giovanni de Girolamo, MD;
Josep Maria Haro, MD, MPH, PhD;
Robert Jin, MA;
Elie G. Karam, MD;
Viviane Kovess-Masfety, MD, PhD;
Daphna Levinson, PhD;
Maria Elena Medina Mora, PhD;
Yutaka Ono, MD, PhD;
Johan Ormel, PhD;
Beth-Ellen Pennell, MA;
Jose Posada-Villa, MD;
Nancy A. Sampson, BA;
David Williams, PhD, MPH;
Ronald C. Kessler, PhD
Arch Gen Psychiatry. 2009;66(7):785-795.
Context Gender differences in mental disorders, including more anxiety and mood disorders among women and more externalizing disorders among men, are found consistently in epidemiological surveys. The gender roles hypothesis suggests that these differences narrow as the roles of women and men become more equal.
Objectives To study time-space (cohort-country) variation in gender differences in lifetime DSM-IV mental disorders across cohorts in 15 countries in the World Health Organization World Mental Health Survey Initiative and to determine if this variation is significantly related to time-space variation in female gender role traditionality as measured by aggregate patterns of female education, employment, marital timing, and use of birth control.
Design Face-to-face household surveys.
Setting Africa, the Americas, Asia, Europe, the Middle East, and the Pacific.
Participants Community-dwelling adults (N = 72 933).
Main Outcome Measures The World Health Organization Composite International Diagnostic Interview assessed lifetime prevalence and age at onset of 18 DSM-IV anxiety, mood, externalizing, and substance disorders. Survival analyses estimated time-space variation in female to male odds ratios of these disorders across cohorts defined by the following age ranges: 18 to 34, 35 to 49, 50 to 64, and 65 years and older. Structural equation analysis examined predictive effects of variation in gender role traditionality on these odds ratios.
Results In all cohorts and countries, women had more anxiety and mood disorders than men, and men had more externalizing and substance disorders than women. Although gender differences were generally consistent across cohorts, significant narrowing was found in recent cohorts for major depressive disorder and substance disorders. This narrowing was significantly related to temporal (major depressive disorder) and spatial (substance disorders) variation in gender role traditionality.
Conclusions While gender differences in most lifetime mental disorders were fairly stable over the time-space units studied, substantial intercohort narrowing of differences in major depression was found to be related to changes in the traditionality of female gender roles. Additional research is needed to understand why this temporal narrowing was confined to major depression.
Author Affiliations: Medical Research Council Research Unit on Anxiety and Stress Disorder, Cape Town, South Africa (Dr Seedat); Department of Psychological Medicine, Wellington School of Medicine, Otago University, Wellington, New Zealand (Dr Scott); Center for Public Mental Health, Vienna, Austria (Dr Angermeyer); Institute for Social Research, University of Michigan, Ann Arbor (Mss Berglund and Pennell); State University of New York–Stony Brook, Stony Brook (Dr Bromet); Department of Health Sciences, University of Leicester, Leicester, England (Dr Brugha); University Hospital, Gasthuisberg, Leuven, Belgium (Dr Demyttenaere); IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy (Dr de Girolamo); Sant Joan de Deu-SSM, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Spain (Dr Haro); Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts (Mr Jin, Ms Sampson, and Dr Kessler); Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St George Hospital University Medical Center, Beirut, Lebanon (Dr Karam); University of Paris Descartes, EA 4069; and MGEN Foundation for Public Health, Paris, France (Dr Kovess-Masfety); Ministry of Health, Mental Health Services, Jerusalem, Israel (Dr Levinson); National Institute of Psychiatry, Mexico City, Mexico (Dr Medina Mora); Keio University School of Medicine, Tokyo, Japan (Dr Ono); University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (Dr Ormel); Colegio Mayor de Cundinamarca University, Bogata, Colombia (Dr Posada-Villa); and Harvard University School of Public Health, Boston (Dr Williams).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
This Month in Archives of General Psychiatry
Arch Gen Psychiatry. 2009;66(7):690.
FULL TEXT
|
