Are diagnostic criteria, time of episode and occupational impairment important determinants of the female:male ratio for major depression?

This study addresses whether the female preponderance in the 1-year prevalence of major depressive disorder is associated with differences in reporting symptoms or underreporting remote episodes, or the inclusion of work impairment in the case definition. In a sample of 1870 professionals and managers, we find (1) a more restrictive cut-off point for women does not eliminate the differential; (2) males and females equally underreport symptoms for remote episodes; and (3) adding impairment to the case definition marginally affects the F:M ratio. Thus, the large F:M prevalence ratio is not an artifact of ascertainment method, case definition, or differential recall.