Gender Differences in the Perceived Impact of Major Depressive Disorder on Quality of Life: A Cross-Sectional Population Study

Introduction: Major depressive disorder (MDD) is more prevalent in women, but men with MDD may experience higher suicide risk and a different symptom profile. This study investigates the subjective impact of MDD on health-related quality of life (HR-QoL) in males and females. Methods: A cross-sectional analysis was conducted on a representative sample from six Italian regions. MDD diagnoses were determined through semi-structured clinical interviews, and HR-QoL was assessed using the SF-12 questionnaire. Mania, hypomania, and subthreshold hypomanic symptoms were evaluated using the Mood Disorder Questionnaire (MDQ). Results: Women had a higher prevalence of MDD (6.2%) than men (3.5%). However, men with MDD showed significantly lower HR-QoL scores compared to non-depressed males, with a greater difference than that observed in women. No significant sex differences emerged in psychiatric comorbidities, but men showed a trend toward higher MDQ positivity, possibly indicating a different depressive phenotype. Conclusions: Although less frequently diagnosed in men, MDD appears to have a stronger perceived impact on quality of life in males. This finding may reflect under-recognized symptoms such as irritability, hyperactivity, and social rhythm dysregulation. Gender-sensitive screening and intervention strategies are essential to improve early detection and reduce the untreated burden of depression in men, ultimately supporting more equitable mental health outcomes.