Is excess mortality higher in depressed men than in depressed women? A meta-analytic comparison

Background It is not well-established whether excess mortality associated with depression is higher in men than in women. Methods We conducted a meta-analysis of prospective studies in which depression was measured at baseline, where mortality rates were reported at follow-up, and in which separate mortality rates for men and women were reported. We conducted systematic searches in bibliographical databases and calculated relative risks of excess mortality in men and women. Results Thirteen studies were included. Among the people with depression, excess mortality in men was higher than in women (RR=1.97; 1.63-2.37). Compared with non-depressed participants, excess mortality was increased in depressed women (RR=1.55; 95% CI: 1.32-1.82), but not as much as in men (RR=2.04; 95% CI: 1.76-2.37), and the difference between excess mortality in men was significantly higher than in women (p<0.05). Conclusions Excess mortality related to depression is higher in men than in women. Although the exact mechanisms for this difference are not clear, it may point at differential or more intensified pathways leading from depression to increased mortality in depressed men compared to women.