Screening Instruments for the Detection of Male-Specific Symptoms of Unipolar Depression – A Critical Overview

Background:

Epidemiological studies have repeatedly pointed out gender differences in unipolar depression, whereas women have a 1.5 to 3 times higher risk of receiving a diagnosis. This however stands in sharp contrast with the 10 times higher suicide-rate of men, although depression is among the main risk-factors for suicide. Current literature therefore suspects an under-diagnosis of depression in men which is yet to be explained. While there is a vast body of literature covering the influence of gender norms, different symptomatology and use of health care services of men and women, systematic examinations of the role of diagnostic inventories or screening-instruments are currently not available.

Method:

A systematic literature search (database: PubMed) was conducted in order to provide an overview of current male-specific instruments for the detection of depression and to point out research gaps in the field of depression in men.

Results:

After screening of titles and abstracts, 122 relevant titles remained, of which 19 full texts were eligible for a detailed analysis. Gender-specific inventories were used in 8 out of 19 relevant titles. Differences in the prevalence of unipolar depression tend to diminish or even disappear when gender-specific inventories are being used.

Discussion:

Existing male-specific screening-instruments have only partly been validated and gender-specific instruments specifically designed for the detection of depression in primary care are currently lacking.