Anxiety Disorders: Sex Differences in Prevalence, Degree, and Background, But Gender-Neutral Treatment

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Abstract

Background: Anxiety disorders are more prevalent among women than among men.

Objective: The aim of this paper was to investigate to what degree current psychological theories and treatment of anxiety disorders incorporate sex and gender considerations.

Methods: Relevant English, Dutch, German, or French empirical articles published until November 2006 were identified using the PsycINFO and PubMed databases as well as manual searches. The following search terms were used: anxiety disorders and sex differences, anxiety disorders and gender, anxiety disorders and women, anxiety disorders and men; combinations of these terms were used with prevalence, phenotypes, treatment, and therapy. In addition to all the aforementioned combinations, we replaced anxiety disorders with agoraphobia, panic disorder, social phobia, specific phobia, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, and generalized anxiety disorder.

Results: Whereas widespread attention has been paid to sex differences in the prevalence of anxiety disorders and their possible origins, scant attention has been given to these differences in terms of treatment.

Conclusions: Prevention and treatment of anxiety disorders might be more effective if the available knowledge about sex and gender specificity was implemented. Concomitantly, treatment effect studies could be improved by greater consideration of sex and gender throughout the research process. More fundamental research is needed regarding the relationship between sex, gender, and anxiety disorders, particularly in association with other mental disorders that have an unequal prevalence between the sexes.

References (76)

  • MM Kelly et al.

    Sex differences in response to a panicogenic challenge procedure: An experimental evaluation of panic vulnerability in a non-clinical sample

    Behav Res Ther

    (2006)
  • WA Arrindell et al.

    Phobic anxiety in 11 nations: Part II. Hofstede's dimensions of national cultures predict national-level variations

    Personality and Individual Differences

    (2004)
  • DL Chambless et al.

    Sex, sex-role stereotyping and agoraphobia

    Behav Res Ther

    (1986)
  • GS Ginsburg et al.

    Gender role orientation and fearfulness in children with anxiety disorders

    J Anxiety Disord

    (2000)
  • WA Arrindell et al.

    Masculine Gender Role Stress: A potential predictor of phobic and obsessive-compulsive behaviour

    J Behav Ther Exp Psychiatry

    (2003)
  • SE Stewart et al.

    Outcome predictors for severe obsessive-compulsive patients in intensive residential treatment

    J Psychiatr Res

    (2006)
  • RA Gould et al.

    Cognitive behavioral and pharmacological treatment of generalised anxiety disorder: A preliminary metaanalysis

    Behav Res Ther

    (1997)
  • M Hirai et al.

    A meta-analytic study of self-help interventions for anxiety problems

    Behav Ther

    (2006)
  • AC Butler et al.

    The empirical status of cognitive-behavioral therapy: A review of metaanalyses

    Clin Psychol Rev

    (2006)
  • A Oakley
  • P Bebbington

    The origins of sex differences in depressive disorder: Bridging the gap

    Int Rev Psychiatry

    (1996)
  • RC Kessler et al.

    Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication [published correction appears in Arch Gen Psychiatry. 2005;662:7768]

    Arch Gen Psychiatry

    (2005)
  • P Carlbring et al.

    12-Month prevalence of panic disorder with or without agoraphobia in the Swedish general population

    Soc Psychiatry Psychiatr Epidemiol

    (2002)
  • RC Kessler et al.

    Posttraumatic stress disorder in the National Comorbidity Survey

    Arch Gen Psychiatry

    (1995)
  • DH Barlow
  • V Starcevic et al.

    Characteristics of agoraphobia in women and men with panic disorder with agoraphobia

    Depress Anxiety

    (1998)
  • KA Yonkers et al.

    Chronicity, relapse, and illness—course of panic disorder, social phobia, and generalized anxiety disorder: Findings in men and women from 8 years of follow-up

    Depress Anxiety

    (2003)
  • N Breslau et al.

    Traumatic events and posttraumatic stress disorder in an urban population of young adults

    Arch Gen Psychiatry

    (1991)
  • R Gater et al.

    Sex differences in the prevalence and detection of depressive and anxiety disorders in general health care settings: Report from the World Health Organization Collaborative Study on Psychological Problems in General Health Care

    Arch Gen Psychiatry

    (1998)
  • MH Bekker et al.

    Male and female tears: Swallowing versus shedding? The relationship between crying, biological sex and gender

  • DL Chambless

    Sex and phobia [in Dutch]

    Gedragstherapie

    (1988)
  • DL Chambless

    Gender and phobia

  • GL Thorpe et al.
  • L Lampe et al.

    Social phobia in the Australian National Survey of Mental Health and Well-Being (NSMHWB)

    Psychol Med

    (2003)
  • L Peters et al.

    Gender differences in the prevalence of DSM-IV and ICD-10 PTSD

    Psychol Med

    (2006)
  • G Parker et al.

    Is the female preponderance in depression secondary to a primary female preponderance in anxiety disorders?

    Acta Psychiatr Scand

    (2001)
  • HU Wittchen et al.

    Comorbidity and mixed anxiety-depressive disorder: Clinical curiosity or pathophysiological need?

    Hum Psychopharmacol

    (2001)
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