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Geschlechtsspezifische Aspekte bei depressiven Erkrankungen

Gender differences in depression

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Die Depression zählt zu den häufigsten Krankheiten und geht mit einer erheblichen Beeinträchtigung der Lebensqualität einher. In der vorliegenden Übersichtsarbeit sollen geschlechtsspezifische Unterschiede bei der Depression im Symptommuster, Erkrankungsverlauf, hinsichtlich der Komorbidität, bei biologischen und psychosozialen Faktoren, im Einfluss der Geschlechterrolle, im Hilfesuchverhalten und der Emotionsregulierung sowie der Arzt-Patient-Kommunikation dargestellt werden. Frauen erkranken im Vergleich zu Männern fast doppelt so häufig an einer Depression. Der Verlauf ist schwerer. Auch leiden Frauen häufiger unter begleitenden Ängsten. Andererseits sind die Suizidraten für Männer um das 3- bis 5-Fache erhöht, und bei ihnen zählt Alkoholabusus zu den häufigsten Begleiterkrankungen. Bei Männern und Frauen gibt es verschiedene Symptommuster der Depression. Hinweise auf eine männer- und eine frauenspezifische Depression sind allerdings bisher widersprüchlich. Die sozial vermittelten Geschlechterrollen, die mit biologischen Faktoren auf komplexe Weise interagieren, beeinflussen bei Männern und Frauen das Erkrankungsrisiko, das Krankheitsverhalten und die Bewältigung der Depression. Die Bedeutung von Gender für die Definition und den Umgang mit der Depression und die gendersensiblen Anforderungen, die sich für das Gesundheitssystem daraus ergeben, werden bisher zu wenig beachtet.

Abstract

Depression is one of the most prevalent and debilitating diseases. In recent years there has been increased awareness of sex- and gender-specific issues in depression. This narrative review presents and discusses differences in prevalence, symptom profile, age at onset and course, comorbidity, biological and psychosocial factors, the impact of sexual stereotyping, help-seeking, emotion regulation and doctor–patient communication. Typically, women are diagnosed with depression twice as often as men, and their disease follows a more chronic course. Comorbid anxiety is more prevalent in women, whereas comorbid alcohol abuse is a major concern in men. Sucide rates for men are between three and five times higher compared with women. Although there are different symptom profiles in men and women, it is difficult to define a gender-specific symptom profile. Socially mediated gender roles have a significant impact on psychosocial factors associated with risk, sickness behavior and coping strategies. In general, too little attention has been paid to the definition and handling of depression and the gender-related requirements it makes on the healthcare system.

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A. Karger gibt an, dass kein Interessenkonflikt besteht.

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  1. Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland

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Karger, A. Geschlechtsspezifische Aspekte bei depressiven Erkrankungen. Bundesgesundheitsbl. 57, 1092–1098 (2014). https://doi.org/10.1007/s00103-014-2019-z

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