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In my WikiEdu project, my groupmates and I are contributing to the article "Mental Disorders and Gender."

Content Gap:

We noticed a very big introduction that we were thinking about splitting and rewriting it a bit to make the definition, and overview of the article clearer.

We noticed a lack of precise data on how mental disorders can affect men or women in a different way. (Which mental disease? What are the proportions? The causes etc...)

Our contribution to the article:

We also would like to add a section on the gender disparities in mental disorders (on a factual basis/ what kind of mental diseases affect more women or male). In this section, we would like to propose a sub-section about the causes of these disparities (socio-economic, outside pressures etc...)

Any concern:

There are concerns on the article about the tone of the writings so we would like to make sure to stay neutral in our section and maybe check if we can settle any neutrality tone in other parts of it.


Some of my major contributions:

Gender Differences in Mental Health among Women and Men

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Gender-specific Risk Factors

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Gender-specific risk factors increase the likelihood of getting a particular mental disorder based on one's gender. Some gender-specific risk factors that disproportionately affect women are income inequality, low social ranking, unrelenting child care, gender-based violence, and socioeconomic disadvantages.[1]

Anxiety

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Women are two to three times more likely to be diagnosed with General Anxiety Disorder (GAD) than men and have higher self-reported anxiety scores.[2] In the United States, women are two times more likely to be diagnosed with Panic Disorder (PD) than men. Women are also twice as likely to be affected by specific phobias. In addition, Social Anxiety Disorder (SAD) occurs among women and men at similar rates. Obsessive-compulsive Disorder (OCD) affects both women and men equally.[3]


Anxiety can occur with other mental illnesses.[3] Compared to men, women are more likely to have multiple psychiatric disorders in their lifetimes such as a combination of general anxiety disorder and major depression.[4] As a coping mechanism, 30% of men with anxiety use substances.[5] Women also have a higher chance of having an anxiety disorder earlier than men. Girls have an increased likelihood of having an anxiety disorder than boys. Anxiety during a girl’s childhood and adolescence are significantly associated with later depressive episodes and later suicide attempts.[2]


In most cases, anxiety treatment is indifferent to sex. Cognitive behavior therapy (CBT) is around 60-70% successful for both women and men.[5]

Depression

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Regardless of one’s age and country of origin, women are more likely to be diagnosed with depression than men.[6] Major depressive disorder, also known as unipolar depression or MDD, is twice as common in women[6]. Risk factors such as traumatic experiences, gender-based roles, and stress are connected to depression.[1] In the United States and European region, women are more likely to attempt suicide than men.[7] However, the suicide rate in the United States is four times higher for men than women.[8] Another population of women affected by depression is older women. Depression is one of the leading mental disorders of older adults, and women are the majority of older adults with depression.[1]


Although men may have similar diagnosing scores to women, the presence of a gender bias results in an increased diagnosis of depression in women than men.[9]

Postpartum Depression
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Men and women experience postpartum depression. Maternal postpartum depression affects around 13% of women. The rates of female postpartum depression are higher in developing countries at around 20%.[10] Paternal postpartum depression (PPPD) affects 1 out of 10 men. It is associated with a decrease in testosterone and an increase in depressive symptoms. The presence of maternal postpartum depression is a significantly connected to paternal postpartum depression.[11]


In the United States, 1 out of 7 women experiences postpartum depression.[12] In some American states, 1 out of 5 women is affected by postpartum depression.[13]

Eating Disorders

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Women constitute 85-95% of people with anorexia nervosa and bulimia and 65% of those with a binge-eating disorder.[14] Factors that contribute to the gender disproportionality of eating disorders are perceptions surrounding “thinness” in relation to success and sexual attractiveness and social pressures from mass media that are largely targeted towards women.[15] Between males and females, the symptoms experienced by those with eating disorders are very similar such as a distorted body image.[16]


Contrary to the stereotype of eating disorders’ association with females, men also experience eating disorders. However, gender bias, stigma, and shame lead men to be underreported, underdiagnosed, and undertreated for eating disorders.[17] It has been found that clinicians are not well-trained and lack sufficient resources to treat men with eating disorders.[17] Men with eating disorders are likely to experience muscle dysmorphia.[16]

Gender Differences Following a Traumatic Event

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Post-traumatic Stress Disorder (PTSD)
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Post-traumatic stress disorder (PTSD) is among the most common reactions in response to a traumatic event.[18] Research has found that women have higher rates of PTSD compared to men.[19] According to epidemiological studies, women are two to three times more likely to develop PTSD than men.[20] The lifetime prevalence of PTSD is about 10-12% in women and 5-6% in men.[20] Women are also four times more likely to develop chronic PTSD compared to men.[21] There are observed differences in the types of symptoms experienced by men and women.[20] Women are more likely to experience specific sub-clusters of symptoms, such as re-experiencing symptoms (e.g. flashbacks), hypervigilance, feeling depressed and numbness.[20][14] These differences are found to be persistent across cultures.[19] A significant risk factor or trigger of PTSD is rape. In the United States, 65% of men and 45.9% of women who are raped develop PTSD.[3]

Epidemiological studies have found that men are more likely to have PTSD as a result of experiencing combat, war, accidents, nonsexual assaults, natural disaster, and witnessing death or injury.[22] Meanwhile, women are more likely to have PTSD attributed to rape, sexual assault, sexual molestation, and childhood sexual abuse.[22][23] However, despite the theorized explanation that gender differences were due to different rates of exposure to high impact traumas such as sexual assaults, a meta-analysis found that when excluding instances of sexual assault or abuse, women remained at a greater for developing PTSD.[23] Additionally, it has been found that when looking at those who have only experienced sexual assaults, women remained approximately twice as likely as men to develop PTSD.[21] Thus, it is likely that exposure to specific traumatic events such as sexual assault only partially accounts for the observed gender differences in PTSD.[23]

Depression
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While PTSD is perhaps the most well-known psychological response to a trauma, depression can also develop following exposure to traumatic events.[18] Under the definition of sexual assault as pressured or forced into unwanted sexual contact, women encounter two times the rate of sexual assault as men.[24] A history of sexual assault is related to increased rates of depression. For example, studies of survivors of childhood sexual assault found that the rates of childhood sexual assault ranged from 7-19% for women and 3-7% for men. This gender discrepancy in childhood sexual assault contributes to 35% of the gender difference in adult depression.[24] Increased likelihood of adverse traumatic experiences in childhood also explains the observed gender difference in major depression. Studies show that women have an increased risk of experiencing traumatic events in childhood, especially childhood sexual abuse.[25] This risk has been associated with an increased risk of developing depression.[25]


As with PTSD, evidence of a biological difference between men and women may contribute to the observed gender difference. However, research on the biological differences of men and women who have experienced traumatic events is yet to be conclusive.[24]

Gender Differences in Mental Health within the LGBT+ Community

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Risk factors and the Minority Stress Model
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The minority stress model takes into account significant stressors that distinctly affect the mental health of those who identify as lesbian, gay, bisexual, transgender, or another non-conforming gender identity [26]. Some risk factors that contribute to declining mental health are heteronormativity, discrimination, harassment, rejection (e.g., family rejection and social exclusion), stigma, prejudice, denial of civil and human rights, lack of access to mental health resources, lack of access to gender-affirming spaces (e.g., gender-appropriate facilities)[27], and internalized homophobia[26][28]. The structural circumstance where a non-heterosexual or gender non-conforming individual is embedded in significantly affects the potential sources of risk[29]. The compounding of these everyday stressors increase poor mental health outcomes among individuals in the LGBT+ community[29]. Evidence shows that there is a direct association between LGBT+ individuals' development of severe mental illnesses and the exposure to discrimination[30].


In addition, there are a lack of access to mental health resources specific to LGBT+ individuals and a lack of awareness about mental health conditions within the LGBT+ community that restricts patients from seeking help[28].

Limited Research
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There is limited research on mental health in the LGBT+ community. Several factors affect the lack of research on mental illness within non-heterosexual and non-conforming gender identities. Some factors identified: the history of psychiatry with conflating sexual and gender identities with psychiatric symptomatology; medical community's history of labelling gender identities such as homosexuality as an illness (now removed from the DSM); the presence of gender dysphoria in the DSM-V; prejudice and rejection from physicians and healthcare providers; LGBT+ underrepresentation in research populations; physicians' reluctance to ask patients about their gender; and the presence of laws against the LGBT+ community in many countries [30][31]. General patterns such as the prevalence of minority stress have been broadly studied[26].

There is also a lack of empirical research on racial and ethnic differences in mental health status among the LGBT+ community and the intersection of multiple minority identities[29].

Stigmatization of LGBT+ Individuals with Severe Mental Illnesses
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There is a significantly greater stigmatization of LGBT+ individuals with more severe conditions. The presence of the stigma affects individuals' access to treatment and is particularly present for non-heterosexual and gender non-conforming individuals with schizophrenia[30].

Anxiety

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LGBT+ individuals are nearly three times more likely to experience anxiety compared to heterosexual individuals[32]. Gay and bisexual men are more likely to have generalized anxiety disorder (GAD) as compared to heterosexual men[33].

Depression

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Individuals who identify as non-heterosexual or gender non-conforming are more likely to experience depressive episodes and suicide attempts than those who identity as heterosexual[30]. Based solely on their gender identity and sexual orientation, LGBT+ individuals face stigma, societal bias, and rejection that increase the likelihood of depression[28]. Gay and bisexual men are more likely to have major depression and bipolar disorder than heterosexual men[33].

Transgender youth are nearly four times more likely to experience depression, as compared to their non-transgender peers[27]. Compared to LGBT+ youth with highly accepting families, LGBT+ youth with less accepting families are more than three times likely to consider and attempt suicide[27]. As compared to individuals with a level of certainty in their gender identity and sexuality (such as LGB-identified and heterosexual students), youth who are questioning their sexuality report higher levels of depression and worse psychological responses to bullying and victimization[29].

31% of LGBT+ older adults report depressive symptoms. LGBT+ older adults experience LGBT+ stigma and ageism that increase their likeliness to experience depression[32].

Suicide
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As compared to heterosexual men, gay and bisexual men are at a greater risk for suicide, attempting suicide, and dying of suicide[33]. In the United States, 29% (almost one-third) of LGB youth have attempted suicide at least once[34]. Compared to heterosexual youth, LGB+ youth are twice as likely to feel suicidal and over four times as likely to attempt suicide[27]. Transgender individuals are at the greatest risk of suicide attempts[32]. One-third of transgender individuals (both in youth and adulthood) has seriously considered suicide and one-fifth of transgender youth has attempted suicide[27][32].


LGB+ youth are four times more likely to attempt suicide than heterosexual youth[32]. Youth who are questioning their gender identity and/or sexuality are two times more likely to attempt suicide than heterosexual youth[32]. Bisexual youth have higher percentages of suicidality than lesbian and gay youth[29]. As compared to white transgender individuals, transgender individuals who are African American/black, Hispanic/Latinx, American Indian/Alaska Native, or Multiracial are at a greater risk of suicide attempts[32].


39% of LGBT+ older adults have considered suicide[32].

Substance Abuse

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In the United States, an estimate of 20-30% of LGBT+ individuals abuse substances. This is higher than the 9% of the U.S. population that abuse substances. In addition, 25% of LGBT+ individuals abuse alcohol compared to the 5-10% of the general population.[28] Lesbian and bisexual youth have a higher percentage of substance use problems as compared to sexual minority males and heterosexual females[29]. However, as young sexual minority males mature into early adulthood, their rate of substance use increases[29]. Lesbian and bisexual women are twice as likely to engage in heavy alcohol drinking as compared to heterosexual women[32]. Gay and bisexual men are less likely to engage in heavy alcohol drinking as compared to heterosexual men[32].

Substance use such as alcohol and drug use among LGBT+ individuals can be a coping mechanism in response to everyday stressors like violence, discrimination, and homophobia. Substance use can threaten LGBT+ individuals' financial stability, employment, and relationships[33].


See Also

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Gender-bias in medical diagnosis

Healthcare and the LGBT community

Minority stress

  1. ^ a b c "WHO | Gender and women's mental health". WHO. Retrieved 2019-03-20.
  2. ^ a b Donner, Nina; Lowry, Christopher (May 2014). "Sex Differences in Anxiety and Emotional Behavior". Pflugers Archiv. 465 (5): 601–26. doi:10.1007/s00424-013-1271-7. PMC 3805826. PMID 23588380.
  3. ^ a b c "Facts & Statistics | Anxiety and Depression Association of America, ADAA". adaa.org. Retrieved 2019-03-21.
  4. ^ "Facts | Anxiety and Depression Association of America, ADAA". adaa.org. Retrieved 2019-03-21.
  5. ^ a b editor (2015-05-19). "Men and Anxiety". Anxiety Canada. Retrieved 2019-03-21. {{cite web}}: |last= has generic name (help)
  6. ^ a b Doering, Lynn V.; Eastwood, Jo-Ann (2011). "A Literature Review of Depression, Anxiety, and Cardiovascular Disease in Women". Journal of Obstetric, Gynecologic, & Neonatal Nursing. 40 (3): 348–361. doi:10.1111/j.1552-6909.2011.01236.x. ISSN 1552-6909. PMID 21477217.
  7. ^ WHO Regional Committee for Europe. "Fact Sheet -- Mental Health" (PDF). Retrieved March 20, 2019.
  8. ^ American Psychological Association (December 2015). "By the Numbers: Men and Depression". Apa. Retrieved March 20, 2019.
  9. ^ "WHO | Gender and women's mental health". WHO. Retrieved 2019-03-20.
  10. ^ "WHO | Maternal mental health". WHO. Retrieved 2019-03-20.
  11. ^ "Oh Baby: Postpartum Depression in Men is Real, Science Says". PsyCom.net - Mental Health Treatment Resource Since 1986. Retrieved 2019-03-20.
  12. ^ American Psychological Association (2019). "Postpartum Depression". Retrieved March 20, 2019.
  13. ^ "Depression Among Women | Depression | Reproductive Health | CDC". www.cdc.gov. 2019-01-16. Retrieved 2019-03-20.
  14. ^ a b American Psychiatric Association (2017). "Mental Health Disparities: Women's Mental Health" (PDF). Retrieved March 22, 2019.
  15. ^ World Health Organization (2005). "Gender in Mental Health Research" (PDF). Retrieved March 22, 2019.
  16. ^ a b NIH Medline Plus. "Males and Eating Disorders". Retrieved March 25, 2019.
  17. ^ a b Strother, Eric; Lemberg, Raymond; Stanford, Stevie Chariese; Turberville, Dayton (October 2012). "Eating Disorders in men: Underdiagnosed, Undertreated, and Misunderstood". Eating Disorders. 20 (5): 346–355. doi:10.1080/10640266.2012.715512. PMC 3479631. PMID 22985232.
  18. ^ a b Coker, Ann L; Davis, Keith E; Arias, Ileana; Desai, Sujata; Sanderson, Maureen; Brandt, Heather M; Smith, Paige H (1 November 2002). "Physical and mental health effects of intimate partner violence for men and women". American Journal of Preventive Medicine. 23 (4): 260–268. doi:10.1016/s0749-3797(02)00514-7. ISSN 0749-3797. PMID 12406480.
  19. ^ a b Humphreys, Cathy; Thiara, Ravi (1 March 2003). "Mental Health and Domestic Violence: 'I Call it Symptoms of Abuse'". The British Journal of Social Work. 33 (2): 209–226. doi:10.1093/bjsw/33.2.209.
  20. ^ a b c d PhD, Gwenneth L. Roberts; BBus; RN; PhD, Gail M. Williams; MSc; FRC, Joan M. Lawrence; FRANZCP; MD, Beverley Raphael; FRC (1999-01-13). "How Does Domestic Violence Affect Women's Mental Health?". Women & Health. 28 (1): 117–129. doi:10.1300/J013v28n01_08. ISSN 0363-0242. PMID 10022060.
  21. ^ a b McLeer, Susan V; Anwar, A.H. Rebecca; Herman, Suzanne; Maquiling, Kevin (1989-06-01). "Education is not enough: A systems failure in protecting battered women". Annals of Emergency Medicine. 18 (6): 651–653. doi:10.1016/s0196-0644(89)80521-9. ISSN 0196-0644. PMID 2729689.
  22. ^ a b Kessler, Ronald C. (1995-12-01). "Posttraumatic Stress Disorder in the National Comorbidity Survey". Archives of General Psychiatry. 52 (12): 1048–60. doi:10.1001/archpsyc.1995.03950240066012. ISSN 0003-990X. PMID 7492257. S2CID 14189766.
  23. ^ a b c Tolin, David F.; Foa, Edna B. (2006). "Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research". Psychological Bulletin. 132 (6): 959–992. CiteSeerX 10.1.1.472.2298. doi:10.1037/0033-2909.132.6.959. ISSN 1939-1455. PMID 17073529.
  24. ^ a b c Nolen-Hoeksema, Susan (October 2001). "Gender Differences in Depression". Current Directions in Psychological Science. 10 (5): 173–176. doi:10.1111/1467-8721.00142. hdl:2027.42/71710. ISSN 0963-7214. S2CID 1988591.
  25. ^ a b Piccinelli, Marco; Wilkinson, Greg (2000). "Gender differences in depression: Critical review". The British Journal of Psychiatry. 177 (6): 486–492. doi:10.1192/bjp.177.6.486. ISSN 0007-1250. PMID 11102321.
  26. ^ a b c Dentato, Michael (April 2012). "The Minority Stress Perspective". American Psychological Association. Retrieved March 29, 2019.
  27. ^ a b c d e Human Rights Campaign Foundation (July 2017). "The LGBTQ Community" (PDF). Retrieved April 1, 2019.
  28. ^ a b c d National Alliance on Mental Illness. "LGBTQ". Retrieved March 30, 2019.
  29. ^ a b c d e f g Russell, Stephen; Fish, Jessica (2016). "Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth". Annual Review of Clinical Psychology. 12: 465–87. doi:10.1146/annurev-clinpsy-021815-093153. PMC 4887282. PMID 26772206.
  30. ^ a b c d Kidd, Sean; Howison, Meg; Pilling, Merrick; Ross, Lori; McKenzie, Kwame (February 29, 2016). "Severe Mental Illness among LGBT Populations: A Scoping Review". Psychiatric Services. 67 (7): 779–783. doi:10.1176/appi.ps.201500209. PMC 4936529. PMID 26927576.
  31. ^ The Shaw Mind Foundation (2016). "Mental Health in the LGBT Community" (PDF). Retrieved March 29, 2019.
  32. ^ a b c d e f g h i j American Psychiatric Association (2017). "Mental Health Disparities: LGBTQ" (PDF). Retrieved April 1, 2019.
  33. ^ a b c d "Mental Health for Gay and Bisexual Men | CDC". www.cdc.gov. 2019-01-16. Retrieved 2019-04-02.
  34. ^ "LGBT Youth | Lesbian, Gay, Bisexual, and Transgender Health | CDC". www.cdc.gov. 2018-11-19. Retrieved 2019-04-02.
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