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Comment & Response
March 2014

Is It All Depression?—Reply

Author Affiliations
  • 1University of Michigan, Dearborn
  • 2The Institute of Social Research, Program for Research on Black Americans, Research Center for Group Dynamics, University of Michigan, Ann Arbor
  • 3Center for Medicine, Health, and Society, Vanderbilt University, Nashville, Tennessee
JAMA Psychiatry. 2014;71(3):337-338. doi:10.1001/jamapsychiatry.2013.4408

In Reply The websites for both the American Psychiatric Association and National Institute of Mental Health state that men experience depression differently, but few studies have used a nationally representative sample of Americans to examine the veracity of these assertions.1,2 Our study3 examined the hypothesis that part of the sex difference in the prevalence of depression can be attributed to male-female differences in the presentation of depressive symptoms. Our examination of the effect of including male-type symptoms on sex differences in depression was informed by existing empirical measures, clinical reports, and popular claims suggesting that symptoms not included in the DSM-IV (or DSM-5) definition of depression (eg, irritability and anger) may be particularly important for identifying depression in men. While we do not propose that any particular symptoms are exclusive to men’s presentation of depression, we agree with Addis’ Gendered Responding Framework1 that differences in the way men’s and women’s responses to depressed mood and negative effect (eg, rumination, distraction, and avoidance) need to be considered in the application of diagnostic criteria for depression.

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