Although women may experience a stage in which they exhibit the more classic, clinical features of insomnia and loss of appetite, major depressive episodes in women are more likely to include stages of atypical clinical features as well. Another manner in which women differ from men in the course of major mood disorders is that women have easily identified periods of increased risk for the disorder's onset or recurrence. During the postpartum period, both immediately after childbirth and continuing for approximately six months, there is a period of increased vulnerability. Furthermore, a postpartum or premenstrual onset of a major depressive episode indicates the likelihood of another such onset in the future. If a woman's mother or sister has had postpartum periods of depression, she is also at increased risk.
Many studies provide conflicting findings.
For example, there are studies reporting that both women and men take longer to recover from episodes of major depression. However, several well-designed studies suggest that women, particularly older women, are more likely to have chronic depressive episodes. The failure to control for subjects lost to follow-up tends to be associated with reports indicating that women have more recurrences. The studies that account for lost subjects or evaluate all subjects for the entire period of time usually fail to report any differences in recurrences by gender. 2,15,16 Findings on severity of episodes are mixed.