Puberty onset of gender differences in rates of depression: a developmental, epidemiologic and neuroendocrine perspective.

A dramatic feature of the epidemiology of depression is the appearance of a 2:1 female excess of depression during adolescence. In childhood, rates of depression either do not differ between boys and girls or show a slight excess in boys. In this paper we review a number of lines of evidence that implicate the physical and hormonal developments of puberty in this change. We also argue that the analysis of pubertal change in the etiology of depression must take into account the fact that the causation of depression is almost certainly a complex process. In understanding such a process we suggest that developmental epidemiological studies will be of particular value.