A psychosocial understanding of depression in women: for the primary care physician.

This paper has two basic purposes. First, it will provide an understanding of the risks of depression in women, with a focus on the psychosocial factors. The lifetime prevalence of major depression in women ranges from 10% to 23%, twice the rate among men; until puberty, however, rates are similar among boys and girls. The emergence of sex differences at puberty has generated a great deal of research into the biological (in particular, reproductive hormones) and psychosocial factors that may account for this difference and contribute to depression in women across the life cycle. Depression is associated with significant impairment and physical conditions and, thus, clearly constitutes a significant public health problem. The second goal of this paper is to describe some tools for screening depression in the primary care setting. Ten percent to 25% of patients seen by primary care providers have some type of depressive disorder that affects not only their functioning and well-being, but also their physical health. Providers have limited time and expertise for assessing and treating depression. Information about the context of women's lives and an efficient and brief depression screen can help providers evaluate the presence, severity, and impact of depression in their patients.