Sex Differences in cognitive impairment and clinical correlates in Chinese patients with subthreshold depression

Abstract Objective: Subthreshold depression (SD) is a global mental health problem given its high prevalence, comorbidity, functional impairment, and associated with increased service utilization. However, currently little is known about gender differences in SD in cognitive impairment with clinical correlates. The aim of this study was tantamount to explore sex differences in subjective cognitive impairment and clinical associated risk factors in Chinese patients with SD.Methods: A total of 126 SD patients (males/females=40/86, aged 18-45 years) were included in this cross-sectional observational study. The general information, psychological assessments and psychiatric symptom assessments were collected online. The Patient Health Questionnaire-9 (PHQ-9) was used for depressive symptoms, Generalized Anxiety Disorder-7 (GAD-7) was used for anxiety symptoms, Perceived Deficits Questionnaire-Depression (PDQ-D) was used for the cognitive symptoms. Alexithymia was assessed with 20-item Toronto Alexithymia Scale (TAS-20), including 3 subdomains: Factor 1 (F1) evaluated difficulty identifying feelings; Factor 2 (F2) evaluated difficulty describing feelings to others; Factor 3 (F3) evaluated externally oriented thinking. A multivariate analysis of covariance and regression models were used.Results: Our results showed that female patients had significantly higher PDQ-D-20 total score than male patients. However, there were no significant sex differences in the mean TAS-20 and subdomain score. Notably, F2 contributed to cognitive impairment in men, whereas both PHQ-9 aggregate score and F2 contributed to cognitive impairment in women.Conclusion: These findings revealed significant sex differences in cognitive impairments and clinical correlates in SD, which deserves a follow-up study of SD in the future.