Objective: Women are at greater risk for major depression than men. The authors sought to determine whether the gender difference in prevalence for major depression was due to more frequent exposure to stressful life events and/or greater sensitivity to their depressogenic effects.
Method: Male-male, female-female, and male-female twin pairs from a population-based registry were personally interviewed. Each interview assessed the occurrence, to the nearest month, of 18 personal and social network classes of stressful life events and episode onsets of major depression. Standard logistic regression analyses were conducted for the same-sex pairs, and each female twin in the opposite-sex pairs was compared with her male co-twin by using conditional logistic regression.
Results: Women consistently reported higher rates of housing problems, loss of confidant, crises and problems getting along with individuals in their proximal network, and illness of individuals within their distal network. In both the same-sex and opposite-sex samples, men reported higher rates of job loss, legal problems, robbery, and work problems. Consistent sex differences in the depressogenic effect of stressful life events were seen for three event categories: men were more sensitive to the depressogenic effects of divorce or separation and work problems; women were more sensitive to the depressogenic effects of problems getting along with individuals in their proximal network. None of the gender difference in prevalence of major depression could be explained by differing rates of or sensitivities to stressful life events.
Conclusions: Women reported more interpersonal whereas men reported more legal and work-related stressful life events. Most life event categories influenced the risk for major depression similarly in the two sexes. The results suggest that the greater prevalence of major depression in women versus men is due neither to differences in the rates of reported stressful life events nor to differential sensitivity to their pathogenic effect.