Depressive illnesses are counted among the most frequent psychic disorders. In this regard, the prevalence is clearly higher among women (e.g. Busch et al., 2013) and a chronic disease progression occurs more often (e.g. Essau et al., 2010). Depressive women suffer more from accompanying anxieties, while depressive men by contrast suffer from comorbid addictions and their suicide rates are higher. There are differing symptom patterns with men and women, which potentially represent different subtypes of depression (Karger, 2014). While women appear to show more "classic" depressive symptoms, men tend e.g. to more aggression, risky behaviour, a reduction in contacts and substance abuse (Martin et al., 2013). Gender differences in the clinical pictures of depression are seen as a reason for the under-diagnosing of depression and the avoidance in using therapy among men and can also be accompanied by a differing experience of psychotherapy and a difference in the effectiveness of various forms of therapy.
In order to study this, data from the inpatient psychodynamic psychotherapy of depressive men (N=195) and women (N=453) are being evaluated and analysed with the gender differences in the symptomatology and accompanying interpersonal problems as well as in the effectiveness of the inpatient therapy, as indeed in the evaluation of various treatment aspects and forms of therapy (e.g. individual, group, creative therapies, etc.).
In spite of the sparse evidence overall on the effectiveness of inpatient psychodynamic therapy (Liebherz & Rabung, 2010), it proved possible to already validate its effectiveness in two prior studies on the inpatient therapy being assessed here (Huber et al., 2009; Herrmann & Huber, 2013). Interim analyses of a sub-sample indicate that gender differences can be explained in the change caused by a different symptomatology at the beginning of the therapy. Men and women seem to evaluate the treatment differently overall as being helpful. Analyses of the assessment of the various treatment options have still to be concluded.
Viewed from a more long-term perspective, the intention is to prospectively survey the differing forms of depression, and that especially based on the typology of the psychoanalyst S. Blatt, i.e. anaclitic versus introjective, and to examine their effect on the therapy success. Greater knowledge about differences and commonalities could be helpful with the question of the necessity for gender-sensitive psychotherapy with depression.
Prof. Dr. Dr. Dorothea Huber
International Psychanalytic University
Stromstraße 3b, 10555 Berlin und Klinikum München/Clinic for Psychosomatic Medicine and Psychotherapy, Klinikum München-Harlaching Clinic
Dr. Axel Müller
Dr. Ella Fizke
Klinik für Psychosomatische Medizin und Psychotherapie, Klinikum München/Clinic for Psychosomatic Medicine and Psychotherapy, Klinikum München-Harlaching Clinic