Screeninginstrumente zur Erfassung von männerspezifischen Symptomen der unipolaren Depression – Ein kritischer Überblick

Zusammenfassung

Hintergrund Geschlechterunterschiede in der Prävalenz von Depressionen zuungunsten von Frauen sind hinreichend belegt. Dagegen sind wissenschaftliche Publikationen zu diagnostischen Kriterien und Screeninginstrumenten für Geschlechterunterschiede bei Depressionen selten.

Methode Anhand einer systematischen Literatursuche wurden Publikationen recherchiert, die Hinweise für männerspezifische Symptome bei Depressionen bzw. verfügbare Screeninginstrumente geben sollten.

Ergebnisse Von 122 thematisch relevanten Titeln testeten 8 Arbeiten männerspezifische Inventare. Unter Berücksichtigung männertypischer Symptome verringern sich Geschlechterunterschiede in der Prävalenz von Depression.

Diskussion Die Ergebnisse deuten auf einen Bedarf geschlechtersensibler Diagnoseinstrumente für Depressionen hin.

Abstract

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 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 Gender-specific inventories were used in 8 out of 122 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.

Schlüsselwörter

Depression - Screening - Männer - Männerdepression - Übersichtsarbeit

Keywords

depression - screening - men - male depression - systematic review

• Literatur

• 1 Robert Koch-Institut. Depression. Faktenblatt zu GEDA 2012: Ergebnisse der Studie »Gesundheit in Deutschland aktuell 2012«. Berlin: Robert Koch-Institut; 2014
• 2 Robert Koch-Institut. Diagnose Depression: Unterschiede bei Frauen und Männern. Berlin: Robert Koch-Institut; 2013
• 3 Möller-Leimkühler AM. Men, depression and "male depression". Fortschr Neurol Psychiatr 2009; 77: 412-419
• 4 Magovcevic M, Addis ME. The Masculine Depression Scale: development and psychometric evaluation. Psychol Men Masc 2008; 9: 117-132
• 5 Dietrich S, Mergl R, Rummel-Kluge Ch. Von den ersten Symptomen bis zur Behandlung einer Depression. Wann und bei wem suchen Menschen mit Depression Hilfe? Welche Rolle spielt Stigmatisierung? Ergebnisse einer Befragung im Rahmen eines Kongresses für Menschen mit Depression. Psychiat Prax DOI: 10.1055/s-0042-113237.
• 6 Gaebel W, Kowitz S, Fritze J. et al. Use of health care services by people with mental illness: secondary data from three statutory health insurers and the German Statutory Pension Insurance Scheme. Dtsch Arztebl Int 2013; 110: 799-808
• 7 Sieverding M, Kendel F. Geschlechter(rollen)aspekte in der Arzt-Patient-Interaktion. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55: 1118-1124
• 8 Winkler D, Pjrek E, Kasper S. Anger attacks in depression – evidence for a male depressive syndrome. Psychother Psychosom 2005; 74: 303-307
• 9 Möller-Leimkühler AM, Yücel M. Male depression in females?. J Affect Disord 2010; 121: 22-29
• 10 Möller-Leimkühler A, Heller J, Paulus N. Subjective well-being and ‘male depression’ in male adolescents. J Affect Disord 2007; 98: 65-72
• 11 Robert Koch-Institut. Gesundheitliche Lage der Männer in Deutschland. Beiträge zur Gesundheitsberichterstattung des Bundes. Berlin: Robert Koch-Institut; 2014
• 12 Gruber J, Grube M. Geschlechtsspezifische Aspekte bei unipolarer Depression. DNP 2016; 17: 49-58
• 13 Rutz W. Improvement of care for people suffering from depression. The need for comprehensive education. Int Clin Psychopharmacol 1999; 14 (Suppl. 03) S27-S33
• 14 Zierau F, Bille A, Rutz W. et al. The Gotland Male Depression Scale: a validity study in patients with alcohol use disorder. Nord J Psychiatry 2002; 56: 265-271
• 15 Stromberg R, Backlund LG, Lofvander M. A comparison between the Beckʼs Depression Inventory and the Gotland Male Depression Scale in detecting depression among men visiting a drop-in clinic in primary care. Nord J Psychiatry 2010; 64: 258-264
• 16 Sigurdsson B, Palsson SP, Aevarsson O. et al. Validity of Gotland Male Depression Scale for male depression in a community study: the Sudurnesjamenn study. J Affect Disord 2015; 173: 81-89
• 17 Rice SM, Fallon BJ, Aucote HM. et al. Longitudinal sex differences of externalising and internalising depression symptom trajectories: Implications for assessment of depression in men from an online study. Int J Soc Psychiatry 2015; 61: 236-240
• 18 Rice SM, Fallon BJ, Aucote HM. et al. Development and preliminary validation of the male depression risk scale: Furthering the assessment of depression in men. J Affect Disord 2013; 151: 950-958
• 19 Martin LA, Neighbors HW, Griffith DM. The experience of symptoms of depression in men vs women: analysis of the National Comorbidity Survey Replication. JAMA psychiatry 2013; 70: 1100-1106
• 20 Salokangas RK, Vaahtera K, Pacriev S. et al. Gender differences in depressive symptoms. J Affect Disord 2002; 68: 215-220
• 21 Bertakis KD, Helms LJ, Callahan EJ. et al. Patient gender differences in the diagnosis of depression in primary care. J Womens Health Gend Based Med 2001; 10: 689-698
• 22 Bryson SE, Pilon DJ. Sex differences in depression and the method of administering the beck depression inventory. J Clin Psychol 1984; 40: 529-534
• 23 Hahm HC, Le Cook B, Ault-Brutus A. et al. Intersection of race-ethnicity and gender in depression care: screening, access, and minimally adequate treatment. Psychiatr Serv 2015; 66: 258-264
• 24 Mellsop G, Smith B. Reflections on masculinity, culture and the diagnosis of depression. Aust N Z J Psychiatry 2007; 41: 850-853
• 25 Gater R, Tansella M, Korten A. et al. Sex Differences in the Prevalence and Detection of Depressive and Anxiety Disorders in General Health Care Settings. Arch Gen Psychiatry 1998; 55: 405-413
• 26 Sanfilipo MP. Masculinity, femininity, and subjective experiences of depression. J Clin Psychol 1994; 50: 144-157
• 27 Young MA, Fogg LF, Scheftner WA. et al. Sex differences in the lifetime prevalence of depression. Does varying the diagnostic criteria reduce the female/male ratio?. J Affect Disord 1990; 18: 187-192
• 28 Angst J, Dobler-Mikola A. Do the diagnostic criteria determine the sex ratio in depression?. J Affect Disord 1984; 7: 189-198
• 29 Fennig S, Schwartz JE, Bromet EJ. Are diagnostic criteria, time of episode and occupational impairment important determinants of the female. Male ratio for major depression?. J Affect Disord 1994; 30: 147-154
• 30 Lopez Molina MA, Jansen K, Drews C. et al. Major depressive disorder symptoms in male and female young adults. Psychol Health Med 2014; 19: 136-145