Gender Differences in Epidemiology and Correlates of Major Depressive Disorder and Suicidal Ideation among Asian Americans

Objectives: Research in major depressive disorder (MDD) and suicidal ideation has documented gender differences in prevalence and correlates of MDD and suicidal ideation. However, few studies have investigated the gender differences in the epidemiology and correlates of MDD and suicidal ideation among Asian Americans, the fastest growing population in the US. It is vital to clinicians that ethnic specific research be available to treat patients in the most effective way possible. Also, gender specific demographic characteristics and risk factors can help clinicians to formulate the different presentations of the disorder, to select target behaviors, and to develop gender specific interventions, which may ultimately deliver more effective mental health services among Asian Americans.

This study aims to investigate national prevalence estimates and socio-demographic characteristics of lifetime DSM-IV MDD and lifetime suicidal ideation by gender, and to investigate the similarities and differences in factors associated with lifetime DSM-IV MDD and lifetime suicidal ideation among Asian American women and men.

Methods: Data were derived from the 2002-2003 US National Latino and Asian American Study (NLAAS; total n=2,095; male=997; female=1,097). People between the ages of 18 and 75 years old were included in the analyses. Logistic regression analysis was used to assess factors associated with lifetime DSM-IV MDD and lifetime suicidal ideation. Covariates include age, education, US citizen status, subjective economic status, and acculturative stress.

Findings: No statistical significance was found in either DSM-IV MDD (women 10.1 % vs. men 8.5 %) or suicidal ideation (women 10.8% vs. men 7.8%) among the nationally representative sample of Asian Americans, contrary to abundant research that reports higher rates of DSM-IV MDD and suicidal ideation in women than in men. Similarities and differences were observed in terms of factors associated with DSM-IV MDD and suicidal ideation among men and women. Higher levels of perceived discrimination and higher number of physical illnesses were associated with DSM-IV MDD for both Asian men and Asian women, and were also associated with suicidal ideation for Asian women. Factors associated with suicidal ideation for Asian men included higher levels of perceived discrimination and poor self-assessed health. In addition, lower family cohesion was consistently associated with both DSM-IV MDD and suicidal ideation among Asian women, but not for Asian men.

Discussion: This study highlights the intriguing evidences of similarities and differences in regard to prevalence and factors associated with mental health outcomes of nationally representative samples of Asian American women and men. Approximately one in ten Asian women and approximately eight percent of Asian men were suffering from lifetime DSM-IV MDD and lifetime suicidal ideation. The perceived discrimination and health concepts (both self-assessed health and physical illnesses) had significant roles in mental health outcomes for both Asian men and women. Strengthening family cohesion, particularly among Asian women, could lead to significant reductions in societal and personal burdens and improve the quality of life of those who suffer from MDD and suicidal ideation.