PsychologicalReports, 1992, 7 1 , 939-943. O Psychological Reports 1992
SEX DIFFERENCES IN DEPRESSION OF IRANIAN ADOLESCENTS AZAR MAKAREM Shiraz University Summary.-The purpose of this study was to investigate sex differences on a depression scale for Iranian adolescents. High school students (100 girls and 100 boys), selected randomly from four high schools in Shiraz, completed the Zung Self-rating Depression Scale. Analysis showed no sigdicant differences on the five subscales of Zung's depression scale for boys and for girls. Also, there were no sex differences on the total score for depression. However, comparisons with Byrne's groups of British boys and girls indicated differences for Iranian boys and girls on 2 individual items reached significance, whereas for the British groups differences were significant for 11 of the 20 items.
A number of studies about sex differences in mental disorders have shown that women are more prone to unipolar affective disorders than are men (Weissman & Herman, 1977; Boyd & Weissman, 1981). Also, Weissman and Herman (1977) argued that more women than men suffer from depressive disorders, and sex differences represented a real phenomenon. On the other hand, Leighton, Lambo, Hughes, Leighton, Murphy, and Macklin (1963), in a study of a tribe in Nigeria, and Bash and Bash-Liechti (1969), in a study of rural Iran, reported no sex differences on depression. Also, the studies by Hammen and Padesky (1977) and by Stangler and Printz (1980) of university students indicated no sex differences among college students on depression. Nolen-Hoeksema (1987) offered some possible explanations for the absence of sex differences in depression among college students. She suggested that only women who go to college have good mental health, but men who go to college may be more representative of the mental health of men in general, so even depressed men go to college. However, Radloff (1975), in a study of depression among 18- to 25-year-olds including people who went to college as well as those who did not attend college, observed that mean depression scores of women were significantly higher than the men's mean scores. Sirmlarly, Faden (1977), in a study of depression among a group of 18- to 24-year-old college students and people not in college, concluded that the absence of sex differences on depression among college students does not generahze to the rest of the age group who are not in college, so college women are self-selected for positive mental health. Previous findings of sex differences on depression in Iran indicated that 'This research was supported by the Shiraz University, which support is gratefully acknowl5dged. Address correspondence to A. Makaremi, Department of Psychology, College of Literature and Human Sciences, Shiraz University, Shiraz, Iran.
940
A. MAKAREMI
girls showed more depression than boys (Valentine, 1959; Mehryar & Shapurian, 1970). But, Makaremi (1989) found no sex differences on depression of high school and college students. Nolen-Hoeksema (1987), in reviewing the literature for sex differences on depression, declared that, although hormonal fluctuations strongly affected moods of many women, further investigations were required to support sex differences on depression. The purpose of this study was to investigate the sex differences in depression among Iranian adolescents. METHOD Subjects The subjects were 200 high school students (100 girls and 100 boys) selected randomly from four high schools in Slzlraz. These four high schools were selected from different regions in Shuaz to have a sample representing different socioeconomic statuses. Also, two of the schools were for boys and two for girls. The mean ages for girls and boys were 15.8 and 15.9 yr., respectively. Instrument The Zung Self-rating Depression Scale (Zung, 1965) was translated into the Iranian language of Farsi. Item 6 was not acceptable culturally and so it was changed to "I still enjoy being young." This instrument has 20 items which can be completed easily by the subjects. The scale can distinguish depressive illness from other psychiatric diagnoses and has been acceptably validated (Zung, 1965, 1967). The scale covers a broad range of depressive symptomatology, dealing with the areas of pervasive affect, psychological equivalents, and psychological concomitants (Zung, 1965). Procedure The questionnaires, given to the students in normal high school classes, were completed by all juniors enrolled at the time.
RESULTSAND DISCUSSION Means and standard deviations on depression for boys and girls are presented in Table 1. A t test was used to compare the mean scores for girls and boys. The analyses showed no significant differences between the depression scores of girls and boys ( t = 1.01, p ~ 0 . 0 5 ) Also, . on five subscales of depressed ideation, psychological factors, biological features of depression, affective fluctuation, and eating disturbance (t,,,s = 1.94, 1.21, .18, 1.19, .12, p r 0.05), there were no significant differences between girls and boys (Table 2). Since multiple t tests were used for the five scales, according to the Bonferroni Inequality a' = .01 and t' is a critical value only at the .O1 level. Mean scores of girls and boys were compared with the results of Byrne (1981) who reported sex differences in symptoms of depression; the values
IRANLAN ADOLESCENTS: DEPRESSION
TABLE 1 WNS AND STANDARD DEVIATIONS ON TOTAL DEPRESSION SCORESOF ZUNGS E L F - R A ~DEPRESSION G SCALEFORBOYS AND GIRLS
THE
Group
n
M
SD
df
t
Girls Boys
100
47.03
0.98
100
48.52
1.11
198 198
1.01*
*p20.05.
TABLE 2 MEANSAND STANDARD DEVIATIONS ON FIVESUBSCALES OF THE ZUNGSELF-RATING DEPRESSION SCALEFORBOYSA N D G n u (ns = 100) Subscales Depressed Ideation Psychological Factors
Biological Features Affective Fluctuation
Eating Disturbance
Group Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls
are shown in Table 3. Boys scored significantly higher than girls on two items of 20 symptoms of depression assessed by Zung's scale (Items 1 and 6); on the contrary, Byrne found the British girls had significantly higher scores on 11 of the 20 symptoms. These findings showed there were no significant differences on depression for Iranian girls and boys. Also, there were no sex differences on all five subscales of the Zung Self-rating Scale, although on four subscales of depressed ideation, psychological factors, biological features, and eating disturbance boys obtained larger mean scores than girls. Finally, on the item analyses it was observed that significantly more boys declared "I feel downhearted and blue" and "I still enjoy being young" than did girls. The results of this study are consistent with data from the previous studies (Leighton, et al., 1963; Bash & Bash-Liechti, 1969; Harnmen & Padesky, 1977; Stangler & Printz, 1980; Makaremi, 1989). As Hammen and Padesky (1977) stated, college women are more confident than other women in the general population, so they are less depressed. Also, Nolen-Hoeksema (1987) indicated that the lack of sex differences on depression among college students reflects the good mental health among them, a reasonable conclusion from her review of the literature which showed no significant differences on depression for men and women. It has to be mentioned that in
TABLE 3 S w DIFFERENCES BY SYMPTOMS OF DEPRESSION (ZUNG SELF-RATING DEPRESSION SCALEITEMS) Items on Zung Depression Scale Boys (n = 3601 1. I feel down-hearted and blue. 2. Morning is when I feel the best. 3. I have crying spells or feel like it. 4. I have trouble sleeping at night. 5. I eat as much as I used to. 6. I still enjoy sex. (I still enjoy being young.) 7. I notice that I am losing weight. 8. I have trouble with constipation. 9. My heart beats faster than usual. 10. I get tired for no reason. 11. My mind is as clear as it used to be. 12. I find it easy to do things I used to do. 13. I am restless and can't keep still. 14. 1 feel hopeful about the future. 15. I am more irritable than usual. 16. I find it easy to make decisions. 17. I feel that I am useful and needed. 18. My Life is pretty full. 19. I feel that others would be better off if I were dead. 20. I still enjoy the things I used to do. *p
SEX DIFFERENCES IN DEPRESSION OF IRANIAN ADOLESCENTS AZAR MAKAREM Shiraz University Summary.-The purpose of this study was to investigate sex differences on a depression scale for Iranian adolescents. High school students (100 girls and 100 boys), selected randomly from four high schools in Shiraz, completed the Zung Self-rating Depression Scale. Analysis showed no sigdicant differences on the five subscales of Zung's depression scale for boys and for girls. Also, there were no sex differences on the total score for depression. However, comparisons with Byrne's groups of British boys and girls indicated differences for Iranian boys and girls on 2 individual items reached significance, whereas for the British groups differences were significant for 11 of the 20 items.
A number of studies about sex differences in mental disorders have shown that women are more prone to unipolar affective disorders than are men (Weissman & Herman, 1977; Boyd & Weissman, 1981). Also, Weissman and Herman (1977) argued that more women than men suffer from depressive disorders, and sex differences represented a real phenomenon. On the other hand, Leighton, Lambo, Hughes, Leighton, Murphy, and Macklin (1963), in a study of a tribe in Nigeria, and Bash and Bash-Liechti (1969), in a study of rural Iran, reported no sex differences on depression. Also, the studies by Hammen and Padesky (1977) and by Stangler and Printz (1980) of university students indicated no sex differences among college students on depression. Nolen-Hoeksema (1987) offered some possible explanations for the absence of sex differences in depression among college students. She suggested that only women who go to college have good mental health, but men who go to college may be more representative of the mental health of men in general, so even depressed men go to college. However, Radloff (1975), in a study of depression among 18- to 25-year-olds including people who went to college as well as those who did not attend college, observed that mean depression scores of women were significantly higher than the men's mean scores. Sirmlarly, Faden (1977), in a study of depression among a group of 18- to 24-year-old college students and people not in college, concluded that the absence of sex differences on depression among college students does not generahze to the rest of the age group who are not in college, so college women are self-selected for positive mental health. Previous findings of sex differences on depression in Iran indicated that 'This research was supported by the Shiraz University, which support is gratefully acknowl5dged. Address correspondence to A. Makaremi, Department of Psychology, College of Literature and Human Sciences, Shiraz University, Shiraz, Iran.
940
A. MAKAREMI
girls showed more depression than boys (Valentine, 1959; Mehryar & Shapurian, 1970). But, Makaremi (1989) found no sex differences on depression of high school and college students. Nolen-Hoeksema (1987), in reviewing the literature for sex differences on depression, declared that, although hormonal fluctuations strongly affected moods of many women, further investigations were required to support sex differences on depression. The purpose of this study was to investigate the sex differences in depression among Iranian adolescents. METHOD Subjects The subjects were 200 high school students (100 girls and 100 boys) selected randomly from four high schools in Slzlraz. These four high schools were selected from different regions in Shuaz to have a sample representing different socioeconomic statuses. Also, two of the schools were for boys and two for girls. The mean ages for girls and boys were 15.8 and 15.9 yr., respectively. Instrument The Zung Self-rating Depression Scale (Zung, 1965) was translated into the Iranian language of Farsi. Item 6 was not acceptable culturally and so it was changed to "I still enjoy being young." This instrument has 20 items which can be completed easily by the subjects. The scale can distinguish depressive illness from other psychiatric diagnoses and has been acceptably validated (Zung, 1965, 1967). The scale covers a broad range of depressive symptomatology, dealing with the areas of pervasive affect, psychological equivalents, and psychological concomitants (Zung, 1965). Procedure The questionnaires, given to the students in normal high school classes, were completed by all juniors enrolled at the time.
RESULTSAND DISCUSSION Means and standard deviations on depression for boys and girls are presented in Table 1. A t test was used to compare the mean scores for girls and boys. The analyses showed no significant differences between the depression scores of girls and boys ( t = 1.01, p ~ 0 . 0 5 ) Also, . on five subscales of depressed ideation, psychological factors, biological features of depression, affective fluctuation, and eating disturbance (t,,,s = 1.94, 1.21, .18, 1.19, .12, p r 0.05), there were no significant differences between girls and boys (Table 2). Since multiple t tests were used for the five scales, according to the Bonferroni Inequality a' = .01 and t' is a critical value only at the .O1 level. Mean scores of girls and boys were compared with the results of Byrne (1981) who reported sex differences in symptoms of depression; the values
IRANLAN ADOLESCENTS: DEPRESSION
TABLE 1 WNS AND STANDARD DEVIATIONS ON TOTAL DEPRESSION SCORESOF ZUNGS E L F - R A ~DEPRESSION G SCALEFORBOYS AND GIRLS
THE
Group
n
M
SD
df
t
Girls Boys
100
47.03
0.98
100
48.52
1.11
198 198
1.01*
*p20.05.
TABLE 2 MEANSAND STANDARD DEVIATIONS ON FIVESUBSCALES OF THE ZUNGSELF-RATING DEPRESSION SCALEFORBOYSA N D G n u (ns = 100) Subscales Depressed Ideation Psychological Factors
Biological Features Affective Fluctuation
Eating Disturbance
Group Boys Girls Boys Girls Boys Girls Boys Girls Boys Girls
are shown in Table 3. Boys scored significantly higher than girls on two items of 20 symptoms of depression assessed by Zung's scale (Items 1 and 6); on the contrary, Byrne found the British girls had significantly higher scores on 11 of the 20 symptoms. These findings showed there were no significant differences on depression for Iranian girls and boys. Also, there were no sex differences on all five subscales of the Zung Self-rating Scale, although on four subscales of depressed ideation, psychological factors, biological features, and eating disturbance boys obtained larger mean scores than girls. Finally, on the item analyses it was observed that significantly more boys declared "I feel downhearted and blue" and "I still enjoy being young" than did girls. The results of this study are consistent with data from the previous studies (Leighton, et al., 1963; Bash & Bash-Liechti, 1969; Harnmen & Padesky, 1977; Stangler & Printz, 1980; Makaremi, 1989). As Hammen and Padesky (1977) stated, college women are more confident than other women in the general population, so they are less depressed. Also, Nolen-Hoeksema (1987) indicated that the lack of sex differences on depression among college students reflects the good mental health among them, a reasonable conclusion from her review of the literature which showed no significant differences on depression for men and women. It has to be mentioned that in
TABLE 3 S w DIFFERENCES BY SYMPTOMS OF DEPRESSION (ZUNG SELF-RATING DEPRESSION SCALEITEMS) Items on Zung Depression Scale Boys (n = 3601 1. I feel down-hearted and blue. 2. Morning is when I feel the best. 3. I have crying spells or feel like it. 4. I have trouble sleeping at night. 5. I eat as much as I used to. 6. I still enjoy sex. (I still enjoy being young.) 7. I notice that I am losing weight. 8. I have trouble with constipation. 9. My heart beats faster than usual. 10. I get tired for no reason. 11. My mind is as clear as it used to be. 12. I find it easy to do things I used to do. 13. I am restless and can't keep still. 14. 1 feel hopeful about the future. 15. I am more irritable than usual. 16. I find it easy to make decisions. 17. I feel that I am useful and needed. 18. My Life is pretty full. 19. I feel that others would be better off if I were dead. 20. I still enjoy the things I used to do. *p
