Sex differences in psychiatric disorders: origins and developmental influences

Differential vulnerabilities to acquire specific types of psychiatric disorders exist for males and females. Alcoholism, antisocial personality and completed suicide predominate in males, while depression, anxiety, eating disorders, and attempted suicide are more common in females. In this paper evidence is explored to support developmental linkages between these disorders in adults and disorders in childhood and adolescence. The findings of this review support the assumption that various disorders of children showing sex differences in prevalence rates are precursors of adult disorders with a similar sex ratio. Longitudinal studies of personality development also provide data supporting the idea that sex-related behavioral predispositions originating early in life may contribute to differences in prevalence rates at subsequent points in the life cycle. Biological and social mechanisms that help explain the nature of these vulnerabilities are explored in some detail. The biological mechanisms considered relate to the pre- and postnatal effects of androgens on the brain and hormonal mechanisms associated with sex chromosomal aberrations. The social factors considered include differences in the rearing of male and female infants, and variations in life-style. Research directions to further explore sex differences in psychiatric disorders are suggested. Such studies are important because they may lead to a better understanding of genetic-brain-behavioral relationships. Secular trends in sex-related socialization practices may also explain why changes in the incidence and age of onset of some types of psychiatric disorder are occurring.