Mood, Anxiety Disorders Diagnosed More in Women Than Men

Doctors diagnose women with a range of mental illnesses more often than they diagnose men and often use different courses of treatment for the two genders, according to researchers from several prominent U.S. institutions.

Gender is known to have a significant influence on mental health, in terms of both the types of illnesses present in the individual and the chances of receiving a diagnosis for specific illnesses. In a study published in December 2014 in the Archives of Women’s Mental Health, researchers from five U.S. institutions assessed the odds that women of childbearing age and their male counterparts will receive a diagnosis for certain mental health conditions. These researchers also looked at the gender-specific use of medications called atypical antipsychotics as treatment for the conditions under considerations.

Gender and Mental Health

Women have known, inherent risks for certain forms of mental illness as a result of hormone fluctuations associated with monthly menstruation, pregnancy/childbirth and menopause. Specific conditions in women at least partially related to hormonal changes over the course of their lifetimes include major depression and female-only illnesses called postpartum depression and postpartum psychosis. However, it’s important to note that much of women’s risks for mental illness have an environmental basis. For example, women have much higher chances than men of experiencing sexual assault (one of the most likely sources of post-traumatic stress disorder or PTSD). Women also have higher chances than men of living in socioeconomically disadvantageous circumstances, in addition to bearing much of the personal and interpersonal stress associated with traditional gender roles in society.

Unfortunately, doctors often set different standards for women when diagnosing and treating mental health issues, the World Health Organization reports. For example, women have higher chances of receiving a depression diagnosis than men, even when they have the same types and number of depression symptoms. When treating mental health problems, doctors are substantially more likely to prescribe antidepressants and other heavy-duty medications to women than to men.

Atypical Antipsychotic Medications

Atypical antipsychotics, also known as second-generation antipsychotics, are mind- and mood-altering medications designed to produce effective treatment results while reducing the risk for serious side effects associated with older antipsychotic medications. Despite the name of these medications, doctors commonly use them for purposes other than the treatment of psychosis (a severe mental illness symptom marked by various types of hallucinations and delusional thoughts/beliefs). Such use is known as “off-label” prescribing. The U.S. Food and Drug Administration has approved 11 antipsychotic medications for use by American physicians. These medications are clozapine (Clozaril), aripiprazole (Abilify), risperidone (Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa), olanzapine/fluoxetine (Symbyax), paliperidone (Invega), lurasidone (Latuda), iloperidone (Fanapt) ziprasidone (Geodon) and asenapine maleate (Saphris).

Which Issues Occurs Most Often?

In the study published in the Archive of Women’s Mental Health, researchers from the Mayo Clinic College of Medicine, Harvard Medical School, the Cleveland Clinic and Harvard-affiliated Massachusetts General Hospital and McLean Hospital used a project involving 1,073 adult men and women between the ages of 18 and 45 to assess how often certain mental illnesses appear in each of the two genders. The researchers used information from the same group of adults to determine how likely people from each gender are to receive specific atypical antipsychotic medications as an outpatient treatment for their condition. All of the male and female participants received at least one such medication. The researchers drew the study participants from a larger group of 4,345 men and women treated for mental health issues at some point between the beginning of 2008 and the end of 2011.

After completing their analysis, the researchers concluded that women who receive atypical antipsychotics as part of their treatment are 59 percent more likely than their male counterparts to receive a major depression diagnosis. Such women also have higher chances than men of receiving a diagnosis for an anxiety disorder (71 percent more likely), bipolar disorder (21 percent more likely) and substance use disorder (37 percent more likely). Conversely, men who receive antipsychotics as part of their treatment have a 47 percent higher chance than women of receiving a diagnosis for a psychosis-producing mental illness.

The researchers also concluded that more than half of all atypical antipsychotic prescribing by doctors is off-label (i.e., not for a psychosis-related illness). Women have substantially higher chances than men of receiving several types of these medications, including aripiprazole and quetiapine. Conversely, men have substantially higher chances of receiving other atypical antipsychotics, including ziprasidone and risperidone.

Posted on December 9th, 2015

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