Depression and its comorbid conditions more serious in women than in men in the United States

Background: Depression is a major public health problem by itself and for its comorbid conditions. We aimed to determine gender differences in the prevalence of depression and how depression is related to comorbid conditions and metabolic biomarkers. Methods: This study included men (n=986) and women (n=1,280) aged 20-79 years who were included in the 2007-2010 National Health and Nutrition Examination Survey. Depression was assessed with the Patient Health Questionnaire (PHQ-9). The associations between depression (PHQ-9 score ≥10), self-reported comorbid conditions, and metabolic biomarkers of comorbid conditions were determined by multivariable logistic regressions adjusting for potential confounders. Results: The prevalence of depression in men and women were 7.9% and 12.1%, respectively (p<0.01). The odds ratios (OR) of various comorbid conditions (asthma, arthritis, gout, coronary heart disease, heart attack, stroke, diabetes mellitus, thyroid problem, and metabolic syndrome) by the status of depression were significantly higher in women. High C-reactive protein (CRP) was a significant predictor of depression in men (OR 2.02, 95% confidence interval [CI] 1.11-3.67) in unadjusted model. In women, high fasting blood glucose, high glycohemoglobin, and high CRP were significant predictors of depression (OR 1.20, 95% CI 1.28-3.01; OR 2.44, 95% CI 1.21-4.92; OR 1.44, 95% CI 1.01-2.06; OR 1.79, 95% CI 0.19-2.67, respectively) after controlling for age, education, race/ethnicity, marital status, ratio of family income to poverty, and physical activity. Conclusions: Women had higher prevalence of depression and higher number of significant associations between socioeconomic status, comorbid conditions, and metabolic risk factors by the status of depression than men. Public health attentions are needed to improve women's mental health.