Project 454713

Depression affects over 264 million people worldwide and is 2 times more common among women than men. However, men have an increased tendency for violent behaviour, substance use, and their rate of suicide is 3 to 4 times higher than women. The typical symptoms of depression include depressed mood, worry, fatigue, and difficulty concentrating. In contrast, some men have atypical symptoms of depression such as anger and irritability, and these symptoms are not represented in clinical guidelines. When clinicians decide on a patient's diagnosis, they often compare them to the 'most common type of patient', and for depression the average patient is a woman with typical depression symptoms. As such, biases in clinical decision-making for depression may explain why men are under diagnosed, which has significant risks when untreated. The goal of this research is to understand if biases in clinical decision-making contribute to sex and gender differences in the diagnosis of depression. We will first invite clinicians to complete a survey that presents them with a series of the same patient cases of depression, but where the sex/gender of the case is randomly chosen. This will see whether the patient's diagnosis given varies when all that differs is their sex/gender. Next, we will interview groups of clinicians to learn about how they diagnose depression, how biases may influence their clinical practice, and explore ways to change these biases. This will be the first study of its kind to evaluate if biases in clinical decision-making contribute to the sex and gender differences seen in depression. Findings of this research provide critical knowledge to improve the diagnosis and outcomes of people living with depression.