Gender differences in help-seeking behavior on two internet forums for individuals with self-reported depression

Abstract Background: The published literature reflects differences between the sexes in the help-seeking behavior of individuals with depression. Professional mental health services reach men to a lesser extent than women. Internet forums are considered an option to better reach males specifically. Objective: We investigated gender differences in the active use of the Internet to access English- and German-language information on depression. Methods: Analysis differentiated contributors' sex for 200 threads (clusters of responses related to one person seeking advice) followed on 2 Internet forums, www.defeatdepression.org , originating from the United Kingdom, and www.verrueckt.de , originating from Germany. From the qualifying date of January 3, 2007, the investigated threads retrospectively reached 149 days. Using 2 variables, “sex ratio of regular Internet users” and “epidemiologically expected sex ratio,” we calculated a hypothetical value for the female-to-male (F:M) ratio of requests for help of 1.23 for the United Kingdom and 1.16 for Germany. Then we compared the actual versus the estimated gender distributions with a 2-sided x2 test. Results: We included 89 queries from www.defeatdepression.org and 97 queries from www.verrueckt.de . On the English-language forum, 46 (52%) of the queries were from women and 43 (48%) from men. On the German-language forum, 67 (69%) of the queries were from women and 30 (31%) from men. The German forum had a significantly higher F:M ratio of contributors compared with the English forum (2.23 vs 1.07, respectively; x2 = 5.885; P = 0.015). The actual F:M ratio of contributors for the English forum was similar to the expected calculation (1.07 actual vs 1.23 expected; x2 = 0.230; P = 0.652), but was significantly lower than the actual versus the expected F:M ratio of contributors for the German forum (2.23 actual vs 1.16 expected; x2 = 4.891; P = 0.027). Conclusion: Possible reasons for the German Internet forum having a higher F:M ratio of contributors compared with the English Internet forum are the differences in presentation style, language, and cultural context between the 2 Web sites.