Consistent gender differences in the duration, chronicity, or acute recurrence of MD have not been found. Longitudinal studies have reported that women recover more slowly than men from a depressive episode and the average duration of an episode is longer in women.[28,29] Therefore, women were significantly more likely to suffer a chronic and recurrent course of illness, with women over age 30 years having the highest rate of recurrent depression.
A retrospective study found a difference in the course of 12-month major depressive episodes, with older women having more recurrent episodes than older men; this difference was most pronounced in women between the ages of 45 and 54 years. A prior history of depression substantially increased the risks of chronicity and 12-month recurrence, and women were more likely than men to have a prior history.
In contrast, cross-sectional studies have not reported any gender differences with respect to chronicity or recurrence of illness.[10,11,25] In the longest naturalistic, prospective, follow-up study to date, 96 men and 101 women with a first episode of MD were followed for an average of 8.4 years. No significant evidence was found for a more chronic course of depression in women than men.
Women also did not significantly differ from men with regard to time to recovery and the overall time to first recurrence. However, a post hoc analysis restricted to the first 6 months after intake revealed one significant difference in that women tended to experience recurrences earlier than men. Milder depressive syndromes were more recurrent in women, but when DSM-IV criteria for major depression were used, the gender difference was not significant, in agreement with previous findings.