Men may have depression just as often as women, but are under diagnosed because doctors put too much stock in the “traditional” symptoms of depression, US researchers say.

Traditionally women have been diagnosed with depression at close to double the rate of men with roughly one in five women experiencing depression.

But depression manifests differently between the sexes and the more “male” symptoms may be overlooked, suggest the University of Michigan authors of a large population-based study.

Once they factored in symptoms like anger, substance abuse and womanising, they found depression affected just over 30% of both men and women at some point in their lives.

Depression was more likely to take an aggressive edge in men, with symptoms like hot tempers, risk taking, and gambling, found the first study to consider “alternative symptoms to measure the prevalence of depression between the sexes.

While depressed women were more likely to cry, withdraw from friends and have trouble sleeping, found the study of 3,300 women and 2,300 men.

Though “male-type” symptoms were also fairly common in women, the authors added.

“Relying on men’s disclosure of traditional symptoms could lead to an under diagnosis of depression in men,” said the authors lead by Dr Lisa Martin.

The current depression criteria may be biased toward detecting symptoms that are more common in men, they said.

“Gender is likely to play an important role in how men and women conceptualise and experience depression,” they wrote in JAMA Psychiatry.

They recommended doctors look for other clues, including the “male-type” symptoms when trying to determine if their male patients are depressed.

As first appeared in Psychiatry Update, 4 September 2013. Source: JAMA Psychiatry, 2013