Sex and Age Disparities in Depression Incidence and Subsequent Hospitalization: A Nationwide Population-Based Cohort Study and Implications for Nursing Practice
Ya-Wen Lin, Fung-Chang Sung, Wei-Fen Ma, Cheng-Li Lin, Ming-Hung LinBackground:
Depression is a leading cause of global disability. Although women consistently exhibit a higher incidence, little is known about how sex and age influence severe outcomes, such as hospitalization.
Objective:
Utilizing one of the world’s largest nationwide cohorts, this study aimed to elucidate these disparities and their implications for nursing practice and mental health care.
Methods:
In this nationwide nested case–control study, we identified more than 1.9 million incident cases of depression from Taiwan’s National Health Insurance Research Database. We compared hospitalization risks by sex, age, and socioeconomic status (SES) using multivariable-adjusted odds ratios (aORs).
Results:
Women exhibited a higher incidence of depression than men (female-to-male adjusted rate ratio = 1.54; 95% confidence interval [CI], 1.53-1.56). Conversely, men with depression had a greater risk of hospitalization (aOR = 1.42; 95% CI, 1.41-1.43). Young adults (18-29 years) had more than a tenfold increased risk of depression-related hospitalization compared with individuals aged 75 years and older. Low-income and blue-collar groups faced nearly threefold higher risks.
Conclusions:
This dissociation between the incidence and severity of depression challenges conventional assumptions and carries significant implications for nursing practice. Nurses and other healthcare professionals play a crucial role in identifying high-risk individuals—particularly men, younger adults, and those of low SES—who may delay seeking help until their condition severely deteriorates. Nursing-led early screening, psychosocial assessment, and continuous follow-up are essential to prevent hospitalization and promote mental health equity.