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Apr 2, 2019

27th European Congress of Psychiatry

07 - A RECONCEPTUALIZATION OF DEPRESSION ELIMINATES GENDER DIFFERENCES IN ITS PREVALENCE IN A RURAL PRIMARY CARE CLINIC IN NORTHERN NEW ENGLAND, USA

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Depression

Internalization

Externalization

Gender

Gender differences

Abstract

Abstract

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Keywords

Depression

Internalization

Externalization

Gender

Gender differences

Abstract

Background and Aims: Within the criteria of the American Psychiatric Association or the International Classification of Disease (ICD), women have a 2-4 fold greater incidence and prevalence of depression than men. Converging research in neurobiology and gender studies made us wonder if reconceptualization of depression as a response to being in a hopeless situation in which one feels helpless (lacking agency) with subtypes of primarily internalizing and primarily externalizing would eliminate current gender differences. Methods: As part of another study, we have been collecting patient life stories. The diagnoses in our samples matched the conventional preponderance of women for depression and men for antisocial or bipolar diagnoses. We developed a rubric for determining from the life story if the person was in a self-perceived hopeless situation in which no opportunity for agency to change could be seen. We then asked if the person was internalizing (classic symptoms of depression with lack of interest, anhedonia, abulia, and loss of capacity to act -- essentially a collapse inward) or externalizing (engaging in risky behaviors, fighting, and being more irritable and/or aggressive -- essentially, purposeless action). We then reviewed the life stories from these perspectives. Results: Within our reconceptualization of depression, gender differences disappeared and the numbers of men and women diagnosed as depressed were equal. Men externalized more, while women externalized more. Conclusions: Gender differences in incidence and prevalence of depression may be more a result of different socialization of men and women for how to respond to feelings of hopelessness and helplessness than of their intrinsic biology.

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© Copyright 2019 Morressier GmbH.
All rights reserved.