Gender Differences in Depression Severity, Gender-Sensitive Symptoms, Resilience, and Stigma in Major Depressive Disorder (GD-GSS-R-S-MDD)

A Comparative Examination of Depression Severity, Gender-Sensitive Depressive Symptoms, Psychological Resilience, and Stigma Levels in Women and Men With Major Depressive Disorder

Depression is a common and serious mental health condition that affects mood, thoughts, behavior, and overall quality of life. It arises from a complex interaction of biological, psychological, and environmental factors. While depression is more frequently diagnosed in women, research suggests that men may experience and express depressive symptoms differently. Men are more likely to display symptoms such as irritability, anger, impulsivity, or increased alcohol use, and they may be less likely to seek professional psychological support due to social expectations and fear of stigma.

Stigma-both self-stigma (internalized negative beliefs about having a mental illness) and perceived social stigma (concerns about being judged by others)-can negatively influence individuals' willingness to seek help and adhere to treatment. In addition, psychological resilience, defined as the ability to cope effectively with stress and adversity, may play an important role in how individuals experience depressive symptoms and respond to treatment.

This study aims to compare women and men diagnosed with Major Depressive Disorder in terms of depression severity, gender-sensitive depressive symptoms, self-stigma, perceived social stigma, and levels of psychological resilience. It will also examine the relationships among these factors to better understand how gender-related differences influence the experience and management of depression.

Findings from this study may contribute to improved recognition of gender-specific features of depression, reduction of stigma, and the development of more individualized and effective mental health interventions for both women and men.

Study Overview

• Status: Recruiting
• Conditions: Major Depressive Disorder (MDD); Resilience, Psychological; Social Stigma; Gender Differences; Self Stigma

• Study Type: Observational
• Enrollment (Estimated): 90

Contacts and Locations

• Study Contact: Name: İrem OZKAYNAK DAGLİ, Research assistant, M.D.; Phone Number: 3600 +90 0222 239 29 79; Email: irem.ozkaynak@ogu.edu.tr
• Study Contact Backup: Name: HARUN O SONKURT, Asst. Prof.; Phone Number: 3600 +90 0222 239 29 79; Email: olcay.sonkurt@ogu.edu.tr

Study Locations

• Turkey (Türkiye)
  • Eskişehir
    • Eskişehir, Eskişehir, Turkey (Türkiye), 26040
      • Recruiting
      • the Department of Psychiatry Outpatient Clinic at Eskişehir Osmangazi University Faculty of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients who presented to the Department of Psychiatry Outpatient Clinic at Eskişehir Osmangazi University Faculty of Medicine.

Description

Inclusion Criteria:

• Male and female patients aged 18 to 65 years
• Diagnosis of Major Depressive Disorder according to DSM-5 at the time of study participation
• Provision of voluntary informed consent

Exclusion Criteria:

• Intellectual disability
• Severe neurological disorders
• Comorbid psychiatric diagnoses
• Depressive disorder secondary to an organic medical condition
• Depressive disorder secondary to substance use

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Women; Female patients aged 18-65 years who were diagnosed with Major Depressive Disorder and presented to the Psychiatry Outpatient Clinic of Eskişehir Osmangazi University Faculty of Medicine
Men; Male patients aged 18-65 years who were diagnosed with Major Depressive Disorder and presented to the Psychiatry Outpatient Clinic of Eskişehir Osmangazi University Faculty of Medicine

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Depression Severity	Depression severity will be assessed using the Beck Depression Inventory (BDI). The Beck Depression Inventory is a 4-point Likert-type scale consisting of 21 items. Each item is rated on a scale of 0 to 3, and the total possible score ranges from 0 to 63. Higher scores indicate a greater severity of depressive symptoms.	Baseline (single assessment)
Gender Differences in Gender-Sensitive Depressive Symptoms	Gender-sensitive depressive symptom severity will be assessed using the Gender-Sensitive Depression Scale, a 24-item, four-point Likert-type instrument. Each item is rated on a four-point scale with response options ranging from 0 to 3: "Never or rarely," "Sometimes," "Often," and "Always." The scale comprises the subdimensions of Dysphoria-Irritability, Impulsivity-Shame, and Alcohol Use. Higher scores indicate greater severity of depressive symptoms.	Baseline (single assessment)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-Stigma in Depression	Self-stigma will be assessed using the Self-Stigma of Depression Scale, a 15-item, five-point Likert-type instrument that measures individuals' self-stigmatizing attitudes and behaviors. One of the 16 items in the original scale was removed during the Turkish validity and reliability study to improve cultural and psychometric appropriateness; therefore, the 15-item version will be used. Each item is rated on a five-point scale ranging from "Strongly disagree" to "Strongly agree," with response options scored from 1 to 5. The total score ranges from 15 to 75, with higher scores indicating greater levels of self-stigma.	Baseline (single assessment)
Perceived Social Stigma Related to Seeking Psychological Help	Perceived social stigma will be assessed using the Stigma Scale for Receiving Professional Psychological Help. The scale consists of five items. Each item is rated on a four-point scale ranging from "Strongly disagree" to "Strongly agree." The total score ranges from 1 to 20. Higher scores indicate a higher level of perceived social stigma associated with seeking psychological help.	Baseline (single assessment)
Psychological Resilience	Psychological resilience will be assessed using the Resilience Scale for Adults, a 32-item, five-point Likert-type instrument. Each item is rated on a five-point scale ranging from "Strongly disagree" to "Strongly agree," with response options scored from 1 to 5. The total score ranges from 32 to 160. The scale does not have a cutoff score, and interpretation of the total score is left to the discretion of the researcher. When higher scores are intended to indicate greater psychological resilience, responses are scored from left to right as 1-2-3-4-5. The scale also includes reverse-scored items.	Baseline (single assessment)

Collaborators and Investigators

• Sponsor: Eskisehir Osmangazi University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2025
• Primary Completion (Estimated): April 1, 2026
• Study Completion (Estimated): November 1, 2026

Study Registration Dates

• First Submitted: March 11, 2026
• First Submitted That Met QC Criteria: March 11, 2026
• First Posted (Actual): March 16, 2026

Study Record Updates

• Last Update Posted (Actual): March 25, 2026
• Last Update Submitted That Met QC Criteria: March 23, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Mood Disorders; Depressive Disorder; Behavior; Social Behavior; Depressive Disorder, Major; Social Stigma
• Other Study ID Numbers: 2025 - 166 / 14

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified individual participant data collected in the study will be shared. This will include demographic variables (e.g., age, gender, education level, marital status), clinical variables related to Major Depressive Disorder, and scale scores obtained from the study instruments. Specifically, the dataset will contain participants' scores on depression severity measures, gender-sensitive depression symptom scales, psychological resilience scales, and stigma measures used in the study. All shared data will be anonymized and will not include any information that could directly identify individual participants.
• IPD Sharing Time Frame: The de-identified individual participant data and supporting materials will be made available beginning 6 months after publication of the study results. The data will remain available for a period of 5 years following publication.
• IPD Sharing Access Criteria: Describe who will be able to access the IPD and supporting information, what they will be able to access, and how they will be able to access it.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No