Gender differences in psychological and cortisol responses to distress: A five-year follow-up of patients with back pain

To further evaluate gender-related coping strategies, clinical and psychological characteristics of patients with low back pain were related to their serum cortisol levels on admission to hospital and at five-year follow-up after operation and/or rehabilitation. Women expressed more somatization and depression than did men on admission, but gender difference disappeared during follow-up while depressive feeling tended to decrease. Men had more cortisol in blood in the afternoon. Sex explained a significant proportion of the variance in cortisol values at admission, whereas depression, sex and operation contributed to variance at follow-up. It was concluded that gender differences in psychological coping with distress modify cortisol responses to the experience of low back pain.