Masculine depression and its problem behaviors: use alcohol and drugs, work hard, and avoid psychiatry!

Summary & key facts

This case-control study compared 163 depressed in-patients (44% women) with 176 controls (51% women). Using a median split on the Male Depression Rating Scale‑22 to label 'masculine' versus 'non-masculine' depression, the study found that masculine depression was linked to worse depression, more frequent and heavy use of alcohol (including binge drinking), more tobacco and illicit drug use, longer working hours, and fewer mental-health-related health service contacts in the past year. These patterns were seen in both women and men, and the authors say patients with masculine depression appear highly burdened and undertreated.

Key facts:

• The study was a case-control design with 163 depressed in-patients (44% women) and 176 controls (51% women).
• Researchers classified patients as having 'masculine' versus 'non-masculine' depression using a median split of the Male Depression Rating Scale‑22.
• Patients with masculine depression had higher depression severity than patients with non-masculine depression.
• Masculine depression (vs. non-masculine depression and vs. no depression) was associated with more frequent and critical alcohol use, including binge drinking.
• Masculine depression was also associated with more tobacco use and more illicit drug use.
• Longer working hours were associated with having masculine depression.
• Fewer health service contacts for mental complaints in the previous year were linked to masculine depression, compared with non-masculine depression.
• Even when substance misuse was critical, it was not significantly linked to more frequent health service contacts; however, higher depression severity was linked to more reported contacts.
• The study reports that these findings applied to both female and male patients and suggests these patterns point to possible targets for specialized care, while noting empirical evidence in this area is still limited.

Abstract

The gender role influences vulnerability to mental illness. Substance use, even critical in scale, is perceived as masculine, just like hard (over-)work, while not seeking help. With the ongoing separation between gender and sex, masculine norms become more relevant also to females' mental health. The male depression concept highlights the role of male symptoms in affective disorders. However, the empirical evidence is still limited. Here, we use the denomination 'masculine depression' to open the category for female patients and tested substance use patterns, health services' utilization, and working hours as predictors in a case-control study of 163 depressed in-patients (44% women; masculine vs. non-masculine depression according to a median split of the Male Depression Rating Scale-22) and 176 controls (51% women). We assessed higher depression severity in patients with masculine (vs. non-masculine) depression. Masculine depression (vs. non-masculine depression and vs. no depression) was predicted by more frequent and critical use of alcohol (including binge drinking), tobacco, and illicit drugs, and by longer working times. Moreover, fewer health services contacts due to mental complaints during the previous year were associated with masculine (vs. non-masculine) depression. Alarmingly, even critical substance misuse was not significantly associated with more frequent health services contacts; however, the higher the depression severity, the more contacts the patients reported. Here, we provide evidence that patients with masculine depression are highly burdened and undertreated, which applies equally to female and male patients. This study identified promising targets to establish specialized care offers.

Topics

Health, psychology, and well-being Sex and Gender in Healthcare Workplace Health and Well-being

Categories

General Health Professions Health Professions Health Sciences

Tags

Clinical psychology Depression (economics) Economics Environmental health Macroeconomics Masculinity Medicine Mental health Poison control Psychiatry Psychoanalysis Psychology Suicide prevention