Challenging depression criteria: An exploration of men's experiences of depression - winner of the Kenneth Lutterman Award for Exemplary Student Paper in Mental Health

Background/Significance: Published data consistently report that women are affected by depression at approximately twice the rate of men. Literature suggests depression may be underdetected in men for two reasons: men may underreport their symptoms and men may exhibit alternative symptoms not included in the diagnostic criteria. Objective/Purpose: Using National Comorbidity Survey-Replication (NCS-R) data, two new depression scales were created to evaluate depression in men: the Male Symptoms Scale (MSS), included "male-type" symptoms of depression as identified from the literature and the Gender Inclusive Depression Scale (GIDS), included alternative and more conventional (i.e., DSM) depression symptoms. Methods: Bivariate analyses examined sex differences in symptom endorsement using two-sided design-based 0.05 level tests. Multivariate logistic regression models were run to identify predictors of depression. Results: Men reported higher rates of anger attacks/aggression, substance use, and risk-taking as compared to women, in both the MSS and AMDS analyses. The MSS identified depression in a significantly higher proportion of men (26.3%) than women (21.9%), (F/M: 0.83, p<.01). The GIDS found that men and women met case criteria for depression in equal proportions, 31% of men, and 33% of women, (F/M: 1.09, NS). Discussion/Conclusions: These findings suggest that depressed men exhibit anger and cope with their depression through destructive outlets. When the alternative and traditional symptoms are combined, the prevalence of depression becomes equalized across the sexes. This raises questions about the validity of existing depression criteria and warrants a re-examination of how we classify depression cases, with particular attention needed to address depression in men.