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PubMed2000

Gender differences in depression. Critical review.

BACKGROUND: With few exceptions, the prevalence, incidence and morbidity risk of depressive disorders are higher in females than in males, beginning at mid-puberty and persisting through adult life. AIMS: To review putative risk factors leading to gender differences in depressive disorders. METHOD: A critical review of the literature, dealing separately with artefactual and genuine determinants of gender differences in depressive disorders. RESULTS: Although artefactual determinants may enhance a female preponderance to some extent, gender differences in depressive disorders are genuine. At present, adverse experiences in childhood, depression and anxiety disorders in childhood and adolescence, sociocultural roles with related adverse experiences, and psychological attributes related to vulnerability to life events and coping skills are likely to be involved. Genetic and biological factors and poor social support, however, have few or no effects in the emergence of gender differences. CONCLUSIONS: Determinants of gender differences in depressive disorders are far from being established and their combination into integrated aetiological models continues to be lacking.

Adaptation, Psychological↗
PubMed2006

Gender differences in the disposition and toxicity of metals.

There is increasing evidence that health effects of toxic metals differ in prevalence or are manifested differently in men and women. However, the database is small. The present work aims at evaluating gender differences in the health effects of cadmium, nickel, lead, mercury and arsenic. There is a markedly higher prevalence of nickel-induced allergy and hand eczema in women compared to men, mainly due to differences in exposure. Cadmium retention is generally higher in women than in men, and the severe cadmium-induced Itai-itai disease was mainly a woman's disease. Gender differences in susceptibility at lower exposure are uncertain, but recent data indicate that cadmium has estrogenic effects and affect female offspring. Men generally have higher blood lead levels than women. Lead accumulates in bone and increased endogenous lead exposure has been demonstrated during periods of increased bone turnover, particularly in women in pregnancy and menopause. Lead and mercury, in the form of mercury vapor and methylmercury, are easily transferred from the pregnant women to the fetus. Recent data indicate that boys are more susceptible to neurotoxic effects of lead and methylmercury following exposure early in life, while experimental data suggest that females are more susceptible to immunotoxic effects of lead. Certain gender differences in the biotransformation of arsenic by methylation have been reported, and men seem to be more affected by arsenic-related skin effect than women. Experimental studies indicate major gender differences in arsenic-induced cancer. Obviously, research on gender-related differences in health effects caused by metals needs considerable more focus in the future.

Disease Susceptibility↗
PubMed2005

Estrogen, testosterone, and gender differences.

The purpose of this report is to gain some current perspective on the definition, bases, and trends for research associated with gender differences. To accomplish this goal an analysis on the number of citations from a 1994-2004 Medline search with the terms estrogen, testosterone, gender differences, sex differences as well as the combinations of these terms was performed. Other combinations of terms included separate searches of estrogen, testosterone, and their combination within males or females, and an analysis of gender and sex differences with the terms human and animal. The salient results from this survey include: (1) An overall greater ratio of estrogen:testosterone citations when these terms were searched alone or in combination with gender differences; (2) an overall greater ratio of testosterone:estrogen citations when these terms were combined with sex differences or conducted separately within males or females, although this trend was shifting toward decreased testosterone and increased estrogen citation numbers toward the latter years of the survey; (3) a trend for increasing numbers of estrogen and gender differences citations over the period of the survey; (4) a clear indication for the term gender differences to be associated with the search term human; and (5) a very small number of citations when the terms estrogen and testosterone were combined. Interpretations and implications of these results are discussed.

Estrogens↗
PubMed1999

The emergence of gender difference in depressed mood during adolescence: the role of intensified gender socialization.

The prevalence of depressive mood was examined in a representative and nationwide sample of approximately 12,000 Norwegian adolescents. From the age of 14, girls scored 0.5 SD above boys in depressed mood, a difference that was stable throughout the adolescent period. At the age of 12, no gender difference was found. The gender difference was due to girls becoming more depressed from 13 to 14 years of age. An extended version of the gender intensification hypothesis (J. P. Hill & M. E. Lynch, 1983) was tested as an explanation for the gender difference in depressed mood. Structural equation modeling and regression analyses showed that the gender difference could be explained, in part, by increased developmental challenges for girls--pubertal development, dissatisfaction with weight and attainment of a mature female body, and increased importance of feminine sex role identification. Depressed mood was not associated with masculinity or school change, as had been predicted.

Adolescent↗
PubMed2001

Gender differences in the metabolism and pharmacokinetics of the experimental anticancer agent 5,6-dimethylxanthenone-4-acetic acid (DMXAA).

PURPOSES: Marked gender differences in the pharmacokinetics of many drugs have been reported. For the investigational anticancer drug, 5,6-dimethylxanthenone-4-acetic acid (DMXAA), negligible gender differences in the plasma pharmacokinetics have been observed in mice. The gender effects on the plasma pharmacokinetics of DMXAA were further investigated using the rat model. In addition, the in vitro metabolism and plasma protein binding of DMXAA in male and female mice, rats and humans were investigated. METHODS: DMXAA was administered to male and female rats by intravenous injection. DMXAA and its major metabolites formed in liver microsomes were determined by HPLC. Unbound DMXAA in plasma was separated by ultrafiltration followed by HPLC determination. RESULTS: In vivo kinetic studies indicated that female rats had 60%, 55% and 73% higher area under the plasma concentration-time curve (AUC) of DMXAA (2413 +/- 188 vs 1505 +/- 312 microM x h, P<0.05), elimination half-life (2.40 +/- 0.45 vs 1.55 +/- 0.33 h) and maximal plasma concentration (Cmax) (1236 +/- 569 vs 716 +/- 280 micro M), but 61% lower plasma clearance than male rats. In vitro studies indicated that male rats had a 67% higher glucuronidation activity (0.75 +/- 0.03 nmol/min per mg) than female rats (0.45 +/- 0.01 nmol/min per mg), resulting in a 96% faster intrinsic clearance (CL(int)) in the males than the females (6.36 +/- 0.65 vs 3.24 +/- .42 ml/min per g, P< 0.05). In contrast, female rats had 25% higher 6-methylhydroxylation activity (0.045 +/- 0.003 nmol/min per mg) than male rats (0.036 +/- 0.002 nmol/min per mg), resulting in a 57% faster intrinsic clearance (CL(int)) in the females than males (0.36 +/- 0.06 vs 0.23 +/- 0.05 ml/min per g). Overall, total CL(int) by both glucuronidation and 6-methylhydroxylation in male rats was 83% higher than in female rats (6.59 +/- 2.11 vs 3.60 +/- 1.07 nmol/min per g). Men ( n=4) had a significantly lower ( P<0.05) CL(int) for glucuronidation than women ( n=10), but a higher CL(int) for 6-methylhydroxylation, resulting in significantly higher total CL(int) in women than men (5.63 vs 8.33 nmol/min per g). There was no significant difference in either the total plasma protein or albumin concentration between male and female mice, rats or humans. CONCLUSION: There were significant gender-related differences in the metabolism and pharmacokinetics in the rat, in contrast to the mouse. This indicates a limited usefulness of the rat as a model for the study of DMXAA metabolism in relation to gender differences, although the gender differences in the in vitro metabolic capacity for DMXAA may provide an explanation for the gender differences in the pharmacokinetics in rats. Data from human liver microsomes may allow the prediction of gender effects in the in vivo pharmacokinetics of DMXAA.

Animals↗
PubMed2005

Gender differences in attitudes among those at risk for Huntington's disease.

This report presents and discusses selected findings regarding gender differences from an Australian-based study that investigated attitudes of individuals at risk for Huntington's disease (HD) towards genetic risk and predictive testing. Clear gender differences emerged regarding perceived coping capacity with regard to predictive testing, as well as disclosure of the genetic risk for HD to others. Female participants were more likely to disclose their genetic risk to others, including their medical practitioners, while male participants were three times more fearful of disclosing their genetic risk to others. These findings are of interest in light of gender differences that have consistently been reported regarding the uptake of predictive testing for HD, other genetic conditions, and health services more generally. While gender differences cannot provide a fully explanatory framework for differential uptake of predictive genetic testing, men and women may experience and respond differently to the genetic risk for HD and possibly other inherited disorders. The meanings of genetic risk to men and women warrants further exploration, given anticipated increases in genetic testing for more common conditions, especially if post-test interventions are possible. These issues are also relevant within the context of individuals' concerns about the potential for discrimination on the basis of genetic risk or genetic test information.

Female↗
PubMed1991

Gender differences in pharmacokinetics and pharmacodynamics of psychotropics: focus on women.

The animal literature provides many instances of gender differences in drug metabolism and/or response. However, there are inherent dangers in trying to generalize findings of either pharmacokinetic or pharmacodynamic gender differences to humans. The literature was searched for references to gender and pharmacokinetics of psychoactive drugs. Interest was primarily in whether sufficient data were available on humans to implicate a gender effect, given the large animal literature. There was a dearth of investigations to look for pertinent differences and many studies that examined gender differences appeared to do so incidentally. Some differences were identified that seemed hormonally influenced and age-related. The most compelling gender differences stem from data on research probes utilized to better understand psychiatric disease processes. The implications for women as psychoactive drug consumers are discussed.

Humans↗
PubMed1995

Gender differences in onset of illness, treatment response, course, and biologic indexes in first-episode schizophrenic patients.

OBJECTIVE: Gender differences in onset of illness, response to treatment, course, and biologic measures have been consistently reported in patients with chronic schizophrenia. Patients with first-episode schizophrenia were examined to determine whether gender differences also occur in these patients. METHOD: Fifty-four neuroleptic-naive schizophrenic patients (29 men and 25 women) were studied beginning in an initial stage of the first hospitalization for psychosis while undergoing treatment with a standardized medication regimen. Before antipsychotic drug treatment and during 1 year of follow-up each patient was rated on the Schedule for Affective Disorders and Schizophrenia--Change Version (psychosis and disorganization items), Scale for the Assessment of Negative Symptoms, Clinical Global Impression, modified Simpson Tardive Dyskinesia Scale, and Simpson-Angus Rating Scale for extrapyramidal side effects. Methylphenidate challenge testing was done at study entry. Plasma neuroleptic, homovanillic acid (HVA), and prolactin levels were determined weekly for the first 6 weeks. RESULTS: The female schizophrenic patients had a later onset and better treatment response than the men. Plasma HVA levels at baseline and week 1 and changes in prolactin levels from baseline to weeks 1 through 6 were greater among the women. CONCLUSIONS: Gender differences in onset and degree of treatment response in first-episode schizophrenic patients are similar to those of chronic patients and are apparent at early stages of the illness. The greater pharmacologic responsivity of the female patients, as indicated by the neuroendocrine results, is consistent with the gender difference in degree of symptom improvement with medication.

Adolescent↗
PubMed1999

Estradiol inhibits leukocyte adhesion and transendothelial migration in rabbits in vivo : possible mechanisms for gender differences in atherosclerosis.

The mechanism by which estrogens protect against atherosclerosis is not known. We evaluated in vivo whether there is a gender difference in monocyte adhesion and subendothelial migration in hypercholesterolemic rabbits and whether any gender differences observed are due to estradiol. Monocyte adhesion and subendothelial migration were assessed in a blinded fashion by analyzing a standardized segment of aorta using a scanning electron microscope. We also assessed whether estradiol modulates induction of vascular cell adhesion molecule-1 (VCAM-1) protein using Western blot and flow cytometric analyses. We observed that male rabbits develop more monocyte adhesion and subendothelial migration than do female rabbits during hypercholesterolemia. We also observed that oophorectomized rabbits given physiological estradiol supplementation demonstrate fewer adherent and subendothelial monocytes than do oophorectomized rabbits given placebo. VCAM-1 protein expression was increased in aortae obtained from hypercholesterolemic, oophorectomized animals supplemented with placebo, and this increase was attenuated by estradiol. Finally, in cultured rabbit aortic endothelial cells stimulated with lysophosphatidylcholine, we observed an increase in VCAM-1 protein that was inhibited in a concentration-dependent fashion by estradiol. We have demonstrated in vivo that there is a gender difference in monocyte adhesion to endothelial cells and transendothelial migration after hypercholesterolemia and that this gender difference is due in part to estradiol. Our results also suggest that estradiol inhibits monocyte adhesion by inhibiting expression of VCAM-1.

Animals↗
PubMed1995

Magnitude of psychological gender differences. Another side to the story.

A. H. Eagly (1995) argued that feminism created a political climate that has lead to research that inaccurately minimizes psychological gender differences. In this article, the authors assert that feminist psychologists do not have a uniform position on this issue, and that many have argued for large gender differences. Meta-analyses indicate great variability in the magnitude of gender differences across different behaviors. However, more psychological gender differences (25%) fall in the close-to-zero range than do other effects in psychology (6%).

Aptitude↗
PubMed2000

[Gender in the brain. A critical scrutiny of the biological gender differences].

Down through history, biological arguments have often been used to legitimize a social gender order characterized by male supremacy. In the 1990's, a lively debate on the biological grounds of gender differences once again emerged in various fields. In the present article, the biological models used for explaining cognitive and behavioral gender differences are scrutinized, and recent research is discussed in light of history. These biological models emanate from theories about sex hormones, genetics and brain anatomy. Regarding the cognitive effects of sex hormones, no consensus has been reached, indicating a need for further research. Studies of relationships between genetics on the one hand and sexual orientation and behavior on the other are theoretically obscure and have thus far failed to prove a trustworthy connection. While there is indeed a difference in total brain size--men's brains are heavier than women's--it is not known whether this difference has any import beyond the fact that men have larger bodies. The existence of differences in brain lateralization and the size of the corpus callosum have been powerfully dismissed in several recent reviews. The design and interpretation of medical research in this field are still colored by gender-stereotyped preconceptions and expectations, which obstructs efforts to gain a solid understanding of the biological differences/similarities between men and women. The media's interest in publicizing research results on gender differences, irrespective of magnitude or practical significance, further alerts us to the importance of scientific reason. There exists a very real risk today that medical gender research may be reduced to research about differences. If this problem is not addressed, it might lead to the reinforcement of the gendered structures of society.

Behavior↗
PubMed1990

Gender differences in mathematics performance: a meta-analysis.

Reviewers have consistently concluded that males perform better on mathematics tests than females do. To make a refined assessment of the magnitude of gender differences in mathematics performance, we performed a meta-analysis of 100 studies. They yielded 254 independent effect sizes, representing the testing of 3,175,188 Ss. Averaged over all effect sizes based on samples of the general population, d was -0.05, indicating that females outperformed males by only a negligible amount. For computation, d was -0.14 (the negative value indicating superior performance by females). For understanding of mathematical concepts, d was -0.03; for complex problem solving, d was 0.08. An examination of age trends indicated that girls showed a slight superiority in computation in elementary school and middle school. There were no gender differences in problem solving in elementary or middle school; differences favoring men emerged in high school (d = 0.29) and in college (d = 0.32). Gender differences were smallest and actually favored females in samples of the general population, grew larger with increasingly selective samples, and were largest for highly selected samples and samples of highly precocious persons. The magnitude of the gender difference has declined over the years; for studies published in 1973 or earlier d was 0.31, whereas it was 0.14 for studies published in 1974 or later. We conclude that gender differences in mathematics performance are small. Nonetheless, the lower performance of women in problem solving that is evident in high school requires attention.

Aptitude↗
PubMed2002

Gender differences in depression. Epidemiological findings from the European DEPRES I and II studies.

BACKGROUND: While there is ample evidence that the prevalence rates for major depressive disorder (MDD) in the general population are higher in women than in men, there is little data on gender differences as regard to symptoms, causal attribution, help-seeking, coping, or the consequences of depression. METHOD: The large DEPRES Study dataset covering representative population samples of six European countries (wave I: 38,434 men and 40,024 women; wave II: 563 men and 1321 women treated for depression) was analyzed for gender differences. RESULTS: In wave I marked gender differences were found in the six-month prevalence rate for major depression but less so for minor depression; the gender differences for major depression persisted across all age groups. Even after stratification by clinically significant impairment and paid employment status, men reported fewer symptoms than women; as a consequence, men reached the diagnostic threshold less often. In wave II there were clear gender differences in causal attribution and in coping. Men coped by increasing their sports activity and consumption of alcohol and women through emotional release and religion. Women felt the effects of depression in their quality of sleep and general health, whereas men felt it more in their ability to work. LIMITATIONS: The second wave of the study comprises treated depressives only and may be less representative than the first wave.

Adaptation, Psychological↗
PubMed2006

Gender differences in pain and secondary hyperalgesia after heat/capsaicin sensitization in healthy volunteers.

UNLABELLED: In most published studies women are more sensitive to experimental pain than men. Enhanced central pain processing in women has been suggested, but psychosocial factors might also have affected the findings. Data from five completed healthy volunteer studies were analyzed to investigate gender differences in development of secondary hyperalgesia. Cutaneous hyperalgesia was induced with the heat/capsaicin sensitization model. Outcome measures were areas of secondary hyperalgesia to brush and von Frey hair stimulation after heat and capsaicin sensitization, rating of pain during heat/capsaicin sensitization, and heat pain detection thresholds. There was a trend toward smaller areas of secondary hyperalgesia in women. After adjusting for estimated gender differences in forearm surface area, areas to brush but not von Frey hair stimulation after capsaicin sensitization were larger in women. Peak pain, but not total pain, during prolonged noxious thermal stimulation was higher in women. There was no gender difference in pain ratings during capsaicin sensitization or in heat pain detection thresholds. The results provided only limited support to the hypothesis that gender differences in clinical pain syndromes can be explained by enhanced central sensitization in women. PERSPECTIVE: Our findings suggest that gender differences in nociceptive transmission and neuronal sensitization are small and provide only limited support to the hypothesis that gender differences in acute and chronic pain syndromes can be explained by enhanced central sensitization in women.

Adult↗
PubMed2006

Gender differences in the metabolic syndrome and their role for cardiovascular disease.

Women live longer than men and develop cardiovascular disease (CVD) at an older age. The metabolic syndrome represents a major risk factor for the development of CVD, and gender differences in this syndrome may contribute to gender differences in CVD. In recent years, the metabolic syndrome has been more prevalent in men than in women. Prevalence is increasing and this increase has been steeper in women, particularly in young women, during the last decade. The contributions of the different components of the metabolic syndrome differ between genders and in different countries. In a recent survey in Germany, 40% of the adult population had been diagnosed with disturbed glucose tolerance or type 2 diabetes. Undiagnosed diabetes was more frequent in men than in women, and risk factors for undiagnosed diabetes differed between the sexes. Worldwide, in individuals with impaired glucose tolerance, impaired fasting glucose was observed more frequently in men, whereas impaired glucose tolerance occurred relatively more often in women. Lipid accumulation patterns differ between women and men. Premenopausal women more frequently develop peripheral obesity with subcutaneous fat accumulation, whereas men and postmenopausal women are more prone to central or android obesity. In particular, android obesity is associated with increased cardiovascular mortality and the development of type 2 diabetes. Visceral adipocytes differ from peripheral adipocytes in their lipolytic activity and their response to insulin, adrenergic and angiotensin stimulation and sex hormones. Visceral fat is a major source of circulating free fatty acids and cytokines, which are directly delivered via the portal vein to the liver inducing insulin resistance and an atherogenic lipid profile. Inflammation increases cardiovascular risk particularly in women. A relatively greater increase in cardiovascular risk by the appearance of diabetes in women has been reported in many studies.Thus, the presently available data suggest that the pathophysiology of the metabolic syndrome and its contribution to the relative risk of cardiovascular events and heart failure show gender differences, which might be of potential relevance for prevention, diagnostics, and therapy of the syndrome.

Cardiovascular Diseases↗
PubMed1996

Gender differences in personality disorders in psychiatrically hospitalized adolescents.

OBJECTIVE: The authors examined gender differences in DSM-III-R personality disorders in adolescent psychiatric inpatients. METHODS: Structured diagnostic interviews were reliably performed with a series of 138 consecutively admitted adolescent inpatients. To reduce variability due to heterogeneity of axis I diagnoses, a subgroup of 87 patients with major depression was retested for gender differences. RESULTS: Females were significantly more likely than males to meet the criteria for borderline personality disorder. Narcissistic personality disorder was diagnosed only in males. A similar pattern was observed in the subgroup of patients with major depression. CONCLUSIONS: The findings suggest potentially important gender differences in personality disorders in adolescent inpatients.

Adolescent↗
PubMed2004

Visceral pain: gender differences in response to experimental and clinical pain.

Gender differences in response to visceral pain have important implications for experimental studies and when evaluating clinical pain. Few studies have in details explored specific gender differences in response to experimental stimulation of selected visceral organs or specific visceral diseases. Lower pain threshold to e.g. oesophageal distension has however been shown in females. The effect of female sex hormones on visceral function and pain is studied in greater details in both experimental and clinical studies. Pronounced differences in pain sensitivity are found across the menstrual phases. This may also interact with pharmacological interventions. For clinicians assessing the pain level of female patients in the reproductive age group should take into consideration the physiological and clinical effects of the menstrual cycle and the somatic segmental sites related to the uterus and cervix when clinically evaluating the pain and assessing for disease activity.

Analgesics↗
PubMed2000

Women in treatment: within-gender differences in the clinical presentation of opioid-dependent women.

Despite consistent evidence of gender differences in the nature of drug dependence, there has been little consideration of within-gender differences in the clinical presentation of drug-abusing women. In this study, cluster analysis and standardized ratings obtained from 153 women seeking methadone maintenance treatment were used to define four groups of women with different profiles of problem severity. The four clusters were characterized as Unemployed, Medically Ill, Psychiatrically Distressed, and Higher Functioning. When the validity of this four-cluster solution was examined, there were significant differences in the ethnic composition of the four groups, and the four clusters differed in terms of a) psychiatric status, b) medical status, c) vocational-educational history, d) lifetime history of maltreatment, and e) perception of social support available from friends and family. The findings suggest that, although understanding of gender differences cannot be ignored, understanding of ways women differ from one another may be as important in the development of gender-sensitive treatment programs.

Adult↗