Gender and Its Effects on Psychopathology is an admirably clear, well-organized collection bringing together review articles by more than twenty authors. Each article details studies that consider gender differences in relation to a particular mental disorder or group of disorders. Although they are not always what one would have expected, the gender differences these studies reveal confirm the rationale for the volume: gender is, in the words of the editor, a “critical player in psychopathology research.”

The volume is arranged, perspicuously, in four sections. The first raises etiological mechanisms for gender difference: biological factors such as the decline in ovarian hormones during the premenstrual, postpartum and menopausal periods and these hormones inherent cyclicity, and psychosocial factors such as expectations and assumptions associated with feminine roles. The second and considerably the longest section deals with mood and anxiety disorders, with separate chapters on gender differences in major depression, gender differences in depression during adolescence; gender differences in response to treatments of depression, gender and the role of anxiety in major depression, and gender differences in anxiety disorders . The third section covers schizophrenia. And the fourth and final chapter deals with substance abuse and dependence.

The pattern of findings which emerges from this set of reviews is complex. The findings for depression indicate that, for example, women are more likely to have a first onset of depression during adolescence; women are more prone than men to develop rapid cycling bipolar conditions, and women and men respond differently to a number of treatments, both forms of psychotherapy, and types of psychopharmacology. On the other hand, there appear to be no gender differences in the chronicity of, recurrence of, or speed of episode recover from major depression.

A very thorough study of first episode schizophrenia produced some equally complex conclusions. Contrary to earlier research and traditionally held opinions, this study did not find a higher lifetime risk in men, nor a gender difference in relation to positive and negative core symptoms, syndromes, subtypes and diagnostic categories. But gender differences did show up in the course of the disorder, and in a higher age of onset in women.

In the course of reporting the findings of these studies, the authors take pains to explain the implausibility of several hypotheses offered to explain gender differences ( the view that the higher rate of depression in women is due to a higher rate of dissembling on the part of men, for example, or that women have experienced a greater rate of trauma). Not only are we shown the correlations which do not hold up, we are also introduced to the whole, often flimsy, edifice explaining women’s alleged proneness to certain disorders. This makes Frank’s volume particularly valuable: it clears away a great deal of unscientific guesswork and begins the serious and important task of examining the way in which certain conditions are gender linked and finding out why this might be so.

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