1. Sex Differences in Mental Illness
D. Jeffrey Newport, MD, MS, MDiv
Director, Women’s Reproductive Mental Health
Professor of Psychiatry & Behavioral Sciences and Obstetrics & Gynecology
University of Miami Miller School of Medicine

2. Percentage of Adults with Depression
NCHS Data Brief No. 303, February 2018

3. Age at Onset Of Depression: Sex Differences
United States ECA
Rate
Per
100
Weissman et al. JAMA 1996; 276: 293

4. Percentage of Depressed Adults Reporting Difficulty with Work, Home, or Social Activities
NCHS Data Brief No. 303, February 2018

5. Suicide Rates by Sex
NCHS, National Vital Statistics System, Mortality

6. Anxiety Disorders: Prevalence and Sex Differences
Generalized Anxiety Disorder
Panic Disorder
Social Anxiety Disorder
Overall Prevalence
3.1%
2.7%
6.8%
Prevalence by Sex
Women 2x > Men
Women = Men
Specific Phobias
Obsessive-Compulsive Disorder
PTSD
Overall Prevalence
8.7%
1.0%
3.5%
Prevalence by Sex
Women 2x > Men
Women = Men
Women > Men*
Anxiety & Depression Association of America

7. Is it the biology?

8. PTSD & Trauma Prevalence: Sex & Sexual Orientation
*Rape is most likely trigger. 65% of men and 46% of women who are raped develop PTSD.
Roberts AL (2010) Am J Public Health 100(12):

9. Postpartum Mood Disturbance60 50 40 30 20 10
-2 Years
-1 Year
Childbirth
+1 Yr
+2 Years
Psychiatric
Admissions
Per Month
Psychosis Admissions
Pregnancy
POSTPARTUM BLUES
50%-70% within days
transient, considered nonpathologic
POSTPARTUM DEPRESSION (PPD)
10-20% of adult women
2/3 have onset by 6 weeks postpartum
serious and disabling
POSTPARTUM PSYCHOSIS (PPS)
1-2/1000 live births
70% are affective (bipolar, depression)
Psychiatric emergency
Newport et al. J Clin Psychiatry 2002; 63(suppl 7): 31.
Kendell RE et al. Br J Psychiatry 1987; 150:

10. Stuart S, O’Hara MW. J Psychother Pract Res 1995; 4: 18-29
Interpersonal Therapy for Postpartum Depression Role Transitions / Role Conflict
Problem: new roles → increased demands → lower self-esteem
Goal: combine new roles with those already established
Example – Working Mother
Potential to be overwhelmed
Exacerbated by partner and/or employer being resistant to change
Solution: develop balanced view of her needs & determine expectations of partner & employer
Develop problem focus and potential solutions (actual solution less important than teaching patient to assess her relationships and empowering her to enact change)
Increase partner’s role in childcare
Decrease time spent at work
More flexible work hours
Alternative child care
Stuart S, O’Hara MW. J Psychother Pract Res 1995; 4: 18-29