The role of gender in depressive mixed state

Gender is an important variable in the study of mood disorders. Study aims were to find the prevalence of women, and to study gender differences in depressive mixed state (DMX), a major depressive episode (MDE) with few concurrent hypomanic symptoms.

Consecutive 173 unipolar and 260 bipolar II MDE outpatients were interviewed with the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version. The variables studied were gender, age, age at onset of the first MDE, number of MDEs, MDE chronicity, atypical, melancholic, and psychotic features, axis I comorbidity, MDE severity, hypomanic symptoms, and DMX3 (DMX defined as MDE plus 3 or more concurrent hypomanic symptoms).

Significantly more females than males had DMX3 vs. non-DMX3 (73.6 vs. 57.8%, p = 0.0006). Females were significantly associated with atypical features and psychomotor agitation in the DMX3 sample.

Findings suggest that females may be more likely than males to have DMX (as defined in the present study), opening the way to speculations about the biological relationship between female gender and DMX. Limitations of the study were a single interviewer and a nonblind assessment.