Gender differences in the effects of bereavement-related psychological distress in health outcomes

BACKGROUND: This study examined whether traumatic grief, depressive and anxiety symptoms formed three distinct factors for widows and widowers. In addition, we examined whether high symptom levels of traumatic grief, depression and anxiety predicted different mental and physical health outcomes for widows and widowers. METHOD: Ninety-two future widows and 58 future widowers were interviewed at the time of their spouse's hospital admission and then at 6 weeks, 6, 13 and 25 month follow-ups. Principal axis factor analyses tested the distinctiveness of traumatic grief, depressive and anxiety symptoms, by gender. Repeated measures ANOVA tested for gender differences and changes over time in mean symptom levels of traumatic grief, depression and anxiety. Linear and logistic regression models estimated the effects of high symptom levels of traumatic grief, depression and anxiety at 6 months on health outcomes at 13 and 25 months post-intake by gender. RESULTS: Three distinct symptom clusters (i.e. traumatic grief, depressive and anxiety symptoms) were found to emerge for both widows and widowers. Widows had higher mean levels of traumatic grief, depressive and anxiety symptoms. High symptom levels of traumatic grief measured at 6 months predicted a physical health event (e.g. cancer, heart attack) at 25 months post-intake for widows. High symptom levels of anxiety measured at 6 months predicted suicidal ideation at 25 months for widowers. CONCLUSIONS: The results suggest that there are gender differences in the levels of psychological symptoms resulting from bereavement and in their effects on subsequent mental and physical health for widows and widowers.     

Gender differences in outcomes of acute mania: a 12-month follow-up study

This study aimed to assess short-term (12 weeks) and long-term (12 months) gender differences in the outcomes of patients experiencing an episode of mania in the course of bipolar disorder. European Mania in Bipolar Longitudinal Evaluation of Medication was a 2-year, prospective, observational study of the outcomes of patients with a manic or mixed episode conducted in 14 European countries. Data were collected during the acute phase (12 weeks) and during a follow-up period (up to 12 months). Analyses were carried out in the subgroup of patients identified with a pure manic episode at baseline. Kaplan–Meier survival analysis estimated time to first occurrence of mania improvement, worsening, recovery and depressive episode, and Cox’s proportional hazards models were used to analyse factors associated with these outcomes. Overall, 2,485 patients (46.6% men, 53.4% women) were included in the analysis. Frequency of substance abuse was higher in men than women. No significant gender differences were found in the severity of manic symptoms at baseline. There were no gender differences in assessment of mania improvement, worsening or recovery over 12 weeks, but more women than men showed mania improvement over 12 months (95.4% vs. 89.2%; p < 0.01). Significantly more women developed a depressive episode over 12 weeks (14.9% vs. 9.7%; p < 0.01) and over 12 months (27.7% vs. 21.5%; p < 0.001). In conclusion, the results show that there are small gender differences in the course of patients experiencing a pure manic episode. Women had a faster time to mania improvement and a higher risk of developing a depressive episode during the 12-month follow-up period.     

Ontogeny of amicable social behavior in the mouse: Gender differences and ongoing isolation outcomes

The behavioral repertoire of male and female outbred CD-1 mice was characterized during development (postnatal Days 23–47). To assess the effects of the rearing condition, half of the subjects were individually housed (IC) at weaning (Day 21), while the remaining mice were housed in pairs (PC) of same-sex siblings. The occurrence of 22 behavioral items was scored during nine social encounters, 3 days apart, between pairs of unfamiliar same-sex and same-condition animals. Individually housed mice were much more involved than paired subjects in solitary play and social interactions (affilitive, investigative, and soliciting behaviors), while less interested in nonsocial behaviors (exploration, and escape-oriented or maintenance activities). An over-days increment for elements of social behavior was evident, with a peak of affiliative behavior at 23–32 days of age. For gender differences, in contrast with rat data, a marked female primacy in both social and playful behaviors was found. Overall, these findings clearly indicate that the behavioral repertoire of developing mice during paired encounters is strongly affected by both the sex of the subjects and the housing condition they are experiencing. © 1993 John Wiley & Sons Inc.     

Gender differences in cardiology

Frequent reports of gender differences in cardiology prompted us to study the cardiological situation in Tyrol, Austria, from 1995 to 2000. Mortality statistics for heart deaths 1995: women 1008 (53.5%), men 875 (46.5%); 2000: women 1104 (58.2%), men 792 (41.8%). Coronary heart deaths 1995: women 572 (50.0%), men 571 (50.0%); 2000: women 634 (54.4%), men 531 (45.6%). Angiograms 1995: women 332 (33.9%), men 646 (66.1%); 2000: women 688 (32.5%), men 1429 (67.5%). Bypass surgery 1995: women 54 (33.0%), men 156 (67.0%); 2000: women 42 (27.5%), men 157 (72.5%). Heart deaths 1995-2000: women +9.5%, men -9.5%; coronary heart deaths 1995-2000: women +10.8%, men -7.0%. By (welcome) contrast, coronary angiograms 1995-2000: women +107.2%, men +121.2%. Bypass operations 1995-2000: women -22.2%, men +0.6%. Life expectancy 1995-2000: women +0.6%, men +0.6%. Patient age at heart death 1995-2000: women +1.8%, men +2.5%. In aggregate, we see that for decades more women than men have died a heart death, but that cardiac mortalities remain a typically "male bastion" with persistent gender differences in access to clinical cardiology. The worsening trend for women begs for awareness programs and corresponding preventive measures.     

Gender differences in treatment outcomes of tuberculosis patients in Taiwan: a prospective observational study

Gender disparities in tuberculosis (TB) cases are reported worldwide, and socio-cultural factors have been proposed as possible causes. To date, gender differences in treatment outcomes of TB patients remain controversial. In this prospective observational study, newly diagnosed, culture-proven TB patients from six hospitals in Taiwan were enrolled for analysis. Gender differences in demographic characteristics and treatment outcomes, including sputum conversion and on-treatment mortality, were analysed accordingly. From January 2007 through to December 2009, a total of 1059 patients were enrolled, including 819 (77.3%) males and 240 (22.7%) females. The ratio of male gender was around 50~60% in TB patients below 35 years and >80% for those older than 65 years. When compared with the female patients, the male patients were older, more likely to have the habit of smoking, chronic obstructive pulmonary disorder, malignancy and liver cirrhosis, and more likely to present with haemoptysis, body weight loss and pleural effusion. Regarding treatment outcomes, male gender is associated with a lower 2-month sputum culture conversion rate (78.8% vs. 89.3%, p 0.002) and higher on-treatment mortality (21.1% vs. 12.1%, p 0.002). Kaplan-Meier survival analysis demonstrated significantly higher mortality in the men (p 0.005). In multivariate analysis, male gender was an independent risk factor for 2-month sputum culture un-conversion (OR, 1.96; 95% CI, 1.12–3.41). Our findings suggest that male gender is associated with older age, more co-morbidities and worse treatment outcomes. Gender-specific strategies, including active case finding in elderly women and smoking cessation in male patients, are warranted to optimize TB management.     

Gender differences at birth and differences in fetal growth

The discrepancy between the number of boys and girls born hasbeen interpreted as a natural selection response to differentialsurvival prospects. There also exists a discrepancy in birthweight, length, head circumference at birth of boys and girls;on the other hand, placental weights were not so strongly biasedby the sex of the fetus. Metabolic differences between the sexesare clearly recognized in adults. It is therefore argued thatthe anthropometric differences at birth, examples of which arepresented in this paper, can only be achieved if the productsof conception are also expressing a sexual bias in metabolismand physiology. It would then be this bias which would determinethe efficiency of the implantation and growth processes andlead to rates of survival to birth. The speculation arisingfrom this and the experimental manipulation of the sex ratiois that the physiological component most likely to be involvedwould be the lipid compartment with its strong sex difference.     

Gender differences in neurodevelopment and epigenetics

The concept that the brain differs in make-up between males and females is not new. For example, it is well established that anatomists in the nineteenth century found sex differences in human brain weight. The importance of sex differences in the organization of the brain cannot be overstated as they may directly affect cognitive functions, such as verbal skills and visuospatial tasks in a sex-dependent fashion. Moreover, the incidence of neurological and psychiatric diseases is also highly dependent on sex. These clinical observations reiterate the importance that gender must be taken into account as a relevant possible contributing factor in order to understand thepathogenesis of neurological and psychiatric disorders. Gender-dependent differentiation of the brain has been detected at every level of organization—morphological, neurochemical, and functional—and has been shown to be primarily controlled by sex differences in gonadal steroid hormone levels during perinatal development. In this review, we discuss howthe gonadal steroid hormone testosterone and its metabolites affect downstream signaling cascades, including gonadal steroid receptor activation, and epigenetic events in order to differentiate the brain in a gender-dependent fashion.     

Gender differences in cortical complexity

Cortical complexity, a measure that quantifies the spatial frequency of gyrification and fissuration of the brain surface, has not been thoroughly characterized with respect to gender differences in the human brain. Using a new three-dimensional (3D) analytic technique with magnetic resonance imaging, we found greater gyrification in women than men in frontal and parietal regions. Increased complexity implies more cortical surface area, which may offset gender differences in brain volume and account for behavioral gender differences.     

Gender differences in sweat lactate

Sweat rate may affect sweat lactate concentration. The current study examined potential gender differences in sweat lactate concentrations because of varying sweat rates. Males (n=6) and females (n=6) of similar age, percentage body fat, and maximal oxygen consumption (VO_2max) completed constant load (CON) cycling (30 min – approximately 40% VO_2max) and interval cycling (INT) (15 1-min intervals each separated by 1 min of rest) trials at 32 (1) °C wet bulb globe temperature (WBGT). Trials were preceded by 15 min of warm-up (0.5 kp, 60 rpms) and followed by 15 min of rest. Blood and sweat samples were collected at 15, 25, 35, 45, and 60 min during each trial. Total body water loss was used to calculate sweat rate. Blood lactate concentrations (CON ≅ 2 mmol · l⁻¹, INT ≅ 6 mmol · l⁻¹) and sweat lactate concentrations (CON and INT ≅ 12 mmol · l⁻¹) were not significantly different (P > 0.05) at any time between genders for CON or INT. Overall sweat rates (ml · h⁻¹) were not significantly different (P > 0.05) between trials but were significantly greater (P ≤ 0.05) for males than for females for CON [779.7 (292.6) versus 450.3 (84.6) ml · h⁻¹] and INT [798.0 (268.3) versus 503.0 (41.4) ml · h⁻¹]. However, correcting for surface area diminished the difference [CON: 390.7 (134.4) versus 277.7 (44.4) ml · h⁻¹, INT: 401.5 (124.1) versus 310.6 (23.4) ml · h⁻¹ (P ≤ 0.07)]. Estimated total lactate secretion was significantly greater (P ≤ 0.05) in males for CON and INT. Results suggest that sweat rate differences do not affect sweat lactate concentrations between genders. Accepted: 7 February 2000     

Gender differences in cardiovascular reactivity

Pronounced cardiovascular reactivity to stress is a behavioral mechanism that may underlie the pathophysiology of coronary heart disease (CHD). Based on the greater incidence of CHD among males than among females, the purpose of the current investigation was to test the hypothesis that in young adults (ages 17–29), males (n=47) show more cardiovascular reactivity than females (n=61) to two stressors, a video game and cigarette smoking. Five of the six comparisons did not support the hypothesis: females were higher on heart rate and diastolic blood pressure reactivity to both Stressors; males were higher on systolic blood pressure reactivity to the video game only. The results suggest that females may be particularly physiologically reactive to cigarette smoking.Conduct of this research was supported by a research grant from the National Heart, Lung, and Blood Institute (HL-36027).     

Gender differences in kidney function

Sex hormones influence the development of female (F) and male (M) specific traits and primarily affect the structure and function of gender-specific organs. Recent studies also indicated their important roles in regulating structure and/or function of nearly every tissue and organ in the mammalian body, including the kidneys, causing gender differences in a variety of characteristics. Clinical observations in humans and studies in experimental animals in vivo and in models in vitro have shown that renal structure and functions under various physiological, pharmacological, and toxicological conditions are different in M and F, and that these differences may be related to the sex-hormone-regulated expression and action of transporters in the apical and basolateral membrane of nephron epithelial cells. In this review we have collected published data on gender differences in renal functions, transporters and other related parameters, and present our own microarray data on messenger RNA expression for various transporters in the kidney cortex of M and F rats. With these data we would like to emphasize the importance of sex hormones in regulation of a variety of renal transport functions and to initiate further studies of gender-related differences in kidney structure and functions, which would enable us to better understand occurrence and development of various renal diseases, pharmacotherapy, and drug-induced nephrotoxicity in humans and animals.     

Gender differences in bipolar affective disorder

We report a study of gender differences in a sample of 111 manic patients. Female manics (N = 78) exhibited fewer manic and more depressive symptoms than males (N = 33). Although male manics had a more frequent history of delayed landmarks, the two groups did not differ in cortical function as measured by EEG and neuropsychological testing. There were no significant differences between male and female relatives of male and female probands for unipolar or bipolar affective disorder, alcoholism or sociopathy. Female relatives of both groups were at greater risk for total affective disorder and male relatives were at greater risk for alcoholism. Familial illness patterns indicated that male and female manics shared the same genetic liability for affective disorder and that X-linked transmission was unlikely.     

Gender differences in smoking cessation.

Gender differences in smoking quit rates are frequently reported and are the subject of much speculation. This study examined the generalizability of gender differences in abstinence across study sites, treatments, and time of relapse, as well as potential mediators and moderators of gender effects. Participants were smokers who participated in 3 randomized clinical trials of the nicotine patch (N = 632). Men had higher cessation rates than women at all follow-ups. The impact of gender on abstinence was unaffected by controlling for study site, treatment, or time of relapse. There was little evidence for mediation or moderation of this relation by any of a host of predictor variables. The magnitude and consistency of the gender differential, coupled with an inability to account for it, highlights a compelling need for additional research specifically aimed at elucidating the relation between gender and abstinence.     

Gender differences in anaerobic power tests

Summary The purpose of this study was to determine if the differences in anaerobic power between males and females could be accounted for by differences in body composition, strength, and neuromuscular function. A total of 82 untrained men and 99 women took part in the study. Body composition, somatotype, isometric strength, neuromuscular function were measured, and four anaerobic power tests performed. The men were significantly different from the women on all strength, power, and neuromuscular measurements except reaction time and on all anthropometric and somatotype dimensions except ectomorphy. Strength and anthropometric dimensions were similarly related to anaerobic power values within each sex. Relative fat (%fat) exerted different degrees of influence on sprint and jump performances in each sex. Removing the influence of anthropometric, strength, and neuromuscular differences by analysis of covariance reduced, but did not remove, the significant differences between the sexes. Therefore, factors other than lean body mass, leg strength, and neuromuscular function may be operating in short-term, explosive power performances to account for the differences between the sexes. The task-specific nature of anaerobic power tests and the relatively large influence of anthropometric factors on power production were confirmed.     

Gender differences in the perception of pungency

Males and females judged the intensity of the typical pungent stimulus CO2, presented by nose and by mouth, employing two scaling procedures: magnitude estimation and magnitude matching. The two groups differed in their perception of CO2 pungency only when it was judged in the nose. Perceived nasal pungency grew as a power function of CO2 concentration, with an exponent of 2.2 for females and 1.6 for males, and the magnitude matching test showed that, relative to their perception of sucrose sweetness, females perceived pungency more intense throughout the range studied. Perceived buccal pungency grew for both groups as the 1.1 power of CO2 concentration, and the magnitude matching test, employing again sweetness as the reference modality, revealed no intensity differences in the perception of buccal pungency between the genders. It is suggested that the susceptibility of the nasal environment to hormonal and neural influences may account for the differences in perceived pungency between males and females.     

Gender differences in alcohol and substance use relapse

This review explores gender differences in relapse and characteristics of relapse events in alcohol and substance use. For alcohol, relapse rates were similar across gender. Although negative mood, childhood sexual abuse, alcohol-related self-efficacy, and poorer coping strategies predicted alcohol relapse, gender did not moderate these effects. Gender did moderate the association between marriage and alcohol relapse. For women, marriage and marital stress were risk factors for alcohol relapse; among men, marriage lowered relapse risk. This gender difference in the role of marriage in relapse may be a result of partner differences in problem drinking. Alcoholic women are more likely to be married to heavy drinking partners than are alcoholic men; thus, alcoholic women may be put at risk of relapse by marriage and alcoholic men may be protected by marriage. There are fewer studies documenting gender differences in substance abuse relapse so conclusions are limited and tentative. In contrast to the lack of gender differences in alcohol relapse rates, women appear less likely to experience relapse to substance use, relative to men. Women relapsing to substance use appear to be more sensitive to negative affect and interpersonal problems. Men, in contrast, may be more likely to have positive experiences prior to relapse.     

Gender differences in strength and muscle fiber characteristics

Summary Strength and muscle characteristics were examined in biceps brachii and vastus lateralis of eight men and eight women. Measurements included motor unit number, size and activation and voluntary strength of the elbow flexors and knee extensors. Fiber areas and type were determined from needle biopsies and muscle areas by computerized tomographical scanning. The women were approximately 52% and 66% as strong as the men in the upper and lower body respectively. The men were also stronger relative to lean body mass. A significant correlation was found between strength and muscle cross-sectional area (CSA; P0.05). The women had 45, 41, 30 and 25% smaller muscle CSAs for the biceps brachii, total elbow flexors, vastus lateralis and total knee extensors respectively. The men had significantly larger type I fiber areas (4597 vs 3483 m²) and mean fiber areas (6632 vs 3963 m²) than the women in biceps brachii and significantly larger type II fiber areas (7700 vs 4040 m²) and mean fiber areas (7070 vs 4290 m²) in vastus lateralis. No significant gender difference was found in the strength to CSA ratio for elbow flexion or knee extension, in biceps fiber number (180 620 in men vs 156 872 in women), muscle area to fiber area ratio in the vastus lateralis 451 468 vs 465 007) or any motor unit characteristics. Data suggest that the greater strength of the men was due primarily to larger fibers. The greater gender difference in upper body strength can probably be attributed to the fact that women tend to have a lower proportion of their lean tissue distributed in the upper body. It is difficult to determine the extent to which the larger fibers in men represent a true biological difference rather that a difference in physical activity, but these data suggest that it is largely an innate gender difference.     

Gender and drug differences in antisocial personality disorder

The relation between childhood behavior disorders (CBD), attentional difficulties (ADD), and antisocial personality disorder (ASP) was examined in a clinical population of alcoholics and polysubstance abusers. Polysubstance abusers reported increased CBD symptomatology, increased attentional problems, a higher rate of ASP, and a greater number of both current and lifetime ASP symptoms relative to alcoholics without polysubstance abuse. An examination of gender effects revealed significant differences on self-reported adult attentional problems, with females endorsing a greater number of items. As a group, females exhibited the highest rate of ASP. Males showed a significant correlation between current ASP symptoms and both attention and conduct problems in early childhood. © 1997 John Wiley & Sons, Inc. J Clin Psychol 53 : 301–305, 1997.     

Gender and age related differences in foot morphology

Objective

This study has assessed age-related changes of foot morphology for developing appropriate footwear with particular reference to the elderly.

Methods

Anatomical parameters such as foot length, circumference and height and ankle length, circumference and height were assessed in a sample of males (n = 577) and females (n = 528) divided into three age groups. The groups included young-adult, aged between 20 and 25 years; adult, aged between 35 and 55 years; and old, aged between 65 and 70 years individuals.

Results

In terms of gender differences, in young-adult individuals the sex-related morphological differences observed, are just related to a significantly lower length of foot in females. In adult subjects morphological parameters investigated were significantly lower in females even after normalization for foot length. In old individuals, no differences of the parameters were found after normalization for foot length. Comparative analysis of morphometric data between young-adult and adult individuals revealed that the instep length was smaller in adults. The opposite was observed for the great toe and medial foot arch height. Length of ankle was higher in adult than in young-adult individuals, whereas ankle circumference and height were smaller. In old vs adult individuals foot circumference showed the most relevant age-related differences.

Conclusions

Feet anatomy presents specific characteristics in different ages of life. The ideal footwear should take into account these characteristics. This is true primarily for the elderly for minimizing the risk of falls or of other problems related to inappropriate footwear.     

Gender differences in subcutaneous and perirenal fat distribution

Purpose  

Body mass index (BMI) has been shown to influence the outcome of various surgical procedures. The purpose of this study is to assess the relationship between BMI, gender, and the distribution of subcutaneous and perirenal fat.