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Occurrence of male depression symptoms, suicidal behaviors, alcohol and tobacco use and level of personal resources in three male groups

  • Aleksandra Kielan1,2
  • Mariusz Jaworski3
  • Anna Mosiołek4
  • Jan Chodkiewicz5
  • Łukasz Święcicki6
  • Bożena Walewska-Zielecka1

1Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, 02-097 Warsaw, Poland

2Polish Suicidological Society, 02-957 Warsaw, Poland

3Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland

4Department of Psychiatry, Faculty of Health Sciences, Medical University of Warsaw, 05-802 Pruszków, Poland

5Department of Psychoprophylaxis and Addiction Psychology, Institute of Psychology, University of Lodz, 91-433 Łódź, Poland

62nd Department of Psychiatry, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland

DOI: 10.31083/jomh.2021.035 Vol.17,Issue 3,July 2021 pp.77-87

Submitted: 09 January 2021 Accepted: 09 February 2021

Published: 08 July 2021

*Corresponding Author(s): Aleksandra Kielan E-mail:

PDF (147.42 kB) Supplementary material


Background and objective: The study was to compare the severity of male depression symptoms, suicidal behaviors, the use of psychoactive substances (alcohol, nicotine), and evaluate personal resources (self-efficacy, coping strategies and resilience) among men from three different groups.

Material and methods: The clinical group contained men with depression disorders diagnosed by psychiatrists and treated in psychiatric hospitals (n = 197). The control groups contained men with physical disorders treated in general hospitals in Warsaw, Poland (n = 198) and men who self-evaluated themselves as healthy without physical or mental disorders (n = 203). Several tests were used for evaluation: a test with sociodemographic variables, the AUDIT Test, the Fagerstrom Test, the Generalized Self-Efficacy Scale (GSES), the MINI-COPE Questionnaire, the Resilience Evaluation Questionnaire (KOP-26), the Suicide Behaviors Questionnaire-Revised by Osman (SBQ-R) and the Gotland Male Depression Scale (GMDS).

Results: Most of the men with depression disorders presented non-typical symptoms of depression which are not included in diagnostic criteria. It allows us to assume that a large percentage of men who suffer from depression are not properly being diagnosed. Moreover, we found that men with any type of physical disorder have the greatest severity of male depression symptoms than healthy men. Men with depression disorders have suicidal thoughts and have made efforts in the past more often, as well as having higher alcohol and nicotine addictions. Patients who overuse or are addicted to alcohol or nicotine should be additionally screened for the possible occurrence of depressive disorders, and substance usage should be treated as a symptom of male depression. Men with depression present low resilience and low self-efficacy. They also use negative strategies in dealing with stress.

Conclusion: There is a need to plan and implement effective prevention actions that will take the conditioning of these groups into account.


Male depression symptoms; Suicide behaviors; Personal resources; Substance-related disorders

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Aleksandra Kielan,Mariusz Jaworski,Anna Mosiołek,Jan Chodkiewicz,Łukasz Święcicki,Bożena Walewska-Zielecka. Occurrence of male depression symptoms, suicidal behaviors, alcohol and tobacco use and level of personal resources in three male groups. Journal of Men's Health. 2021. 17(3);77-87.


[1] Hawton K, Casañas I Comabella C, Haw C, Saunders K. Risk factors for suicide in individuals with depression: a systematic review. Journal of Affective Disorders. 2013; 147: 17–28.

[2] Kielan A, Gorostiza D, Mosiołek A, Chodkiewicz J, Święcicki Ł, Walewska-Zielecka B. Depression in males-specificity, aetiology, relationships with suicidal tendencies and the psychoactive substances usage: literature overview. PostęPy Psychiatrii i Neurologii. 2020; 29: 54–66. (In Polish)

[3] Tsirigotis K, Gruszczynski W, Tsirigotis-Woloszczak M. Gender differentiation in methods of suicide attempts. Medical Science Monitor. 2011; 17: PH65–PH70.

[4] Roy A, Sarchiapone M, Carli V. Low resilience in suicide attempters: relationship to depressive symptoms. Depression and Anxiety. 2007; 24: 273–274.

[5] Stewart RA. Men’s externalizing depression: invariance of the male depression risk scale and latent symptom profiles among African American and European American men. Dissertation, Georgia State University. 2020.

[6] Rosenfield S, Smith D. Gender and mental health: do men and women have different amounts or types of problems. In Horwitz AV, Scheid TL. (eds.) A handbook for the study of mental health: social contexts, theories, and systems (pp. 256–267). Cambridge University Press. 2010.

[7] Smith DT, Mouzon DM, Elliott M. Reviewing the assumptions about men’s mental health: an exploration of the gender binary. American Journal of Men’s Health. 2018; 12: 78–89.

[8] Rice SM, Fallon BJ, Aucote HM, Möller-Leimkühler A, Treeby MS, Amminger GP. Longitudinal sex differences of externalising and inter-nalising depression symptom trajectories: implications for assessment of depression in men from an online study. The International Journal of Social Psychiatry. 2015; 61: 236–240.

[9] Addis ME. Gender and depression in men. Clinical Psychology: Science and Practice. 2008; 15: 153–168.

[10] Pleck JH. The gender role strain paradigm: an update. In Levant RF, Pollack WS. (eds.) A new psychology of men (pp. 11–32). Basic Books. 1995.

[11] Levant RF, Richmond K. The gender role strain paradigm and masculinity ideologies. In Wong YJ, Wester SR. (eds.) APA handbook on men and masculinities (pp. 23–49). American Psychological Association. 2016.

[12] Karpov B, Joffe G, Aaltonen K, Suvisaari J, Baryshnikov I, Koivisto M, et al. Psychoactive substance use in specialized psychiatric care patients. International Journal of Psychiatry in Medicine. 2017; 52: 399–415.

[13] Ali B, Seitz-Brown CJ, Daughters SB. The interacting effect of depressive symptoms, gender, and distress tolerance on substance use problems among residential treatment-seeking substance users. Drug and Alcohol Dependence. 2015; 148: 21–26.

[14] Makara-Studzińska M, Pyłypczuk A, Madej A. The severity of symptoms of depression and anxiety among the addicted to alcohol and gambling. European Journal of Medical Technologies. 2015; 2: 20–29.

[15] Rol P, Chodkiewicz J. Atypical depression symptoms among alcohol-dependent men-the role of aggressiveness, impulsiveness and psy-chache. Advances in Psychiatry and Neurology. 2015; 24: 199–207.

[16] Mental Health America. Stress. 2021. Available at: https://www. (Accessed: 31 March 2021).

[17] Ilgen MA, Downing K, Zivin K, Hoggatt KJ, Kim HM, Ganoczy D, et al. Exploratory data mining analysis identifying subgroups of patients with depression who are at high risk for suicide. The Journal of Clinical Psychiatry. 2009; 70: 1495–1500.

[18] Barsky AJ, Peekna HM, Borus JF. Somatic symptom reporting in women and men. Journal of General Internal Medicine. 2001; 16: 266–275.

[19] Waszczuk J. Pre-suicidal prevention in a global and local dimension-the outline of the issue. Rozprawy Społeczne. 2018; 11: 50–58.

[20] Babor TF. de la Fuente JR, Saunders J, Grant M. AUDIT: The alcohol use disorders identification test: guidelines for use in primary health care. World Health Organization. 1989.

[21] Samodzielny Wojewódzki Zespół Publicznych Zakładów Psychi-atrycznych w Warszawie. Adaptacja i walidacja narzędzia prze-siewowego służącego do rozpoznawania zaburzeń związanych z używaniem alkoholu (Alcohol Use Disorder Identification Test –AUDIT) w warunkach polskich. Państwowa Agencja Rozwiązywania Problemów Alkoholowych. 2018. (In Polish)

[22] Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom K. The fagerstrom test for nicotine dependence: a revision of the fagerstrom tolerance questionnaire. Addiction. 1991; 86: 1119–1127.

[23] Niezabitowska AA, Poprawa RW. Polish adaptation and validation of the modified reasons for the smoking scale. Alcoholism & Drug Addiction. 2020; 33: 119–150.

[24] Juczyński Z. Narzędzia pomiaru w promocji i psychologii zdrowia. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psycho-logicznego. 2001; 167–174. (In Polish)

[25] Carver CS. You want to measure coping but your protocol’s too long: consider the brief COPE. International Journal of Behavioral Medicine. 1997; 4: 92–100.

[26] Juczyński Z, Ogińska-Bulik N. Narzędzia pomiaru stresu i radzenia sobie ze stresem. Pracownia Testów Psychologicznych. 2009. (In Polish)

[27] Gąsior K, Chodkiewicz J, Cechowski W. Resilience measure question-naire (KOP-26). Construction and characteristic of psychological in-struments. In Ostrowski TM, Sikorska I, Gerc K. (eds.) Resilience and health in a fast-changing world (pp. 239–253). Kraków: Jagiellonian University Press. 2015.

[28] Osman A, Bagge CL, Gutierrez PM, Konick LC, Kopper BA, Barrios FX. The suicidal behaviors questionnaire-revised (SBQ-R): validation with clinical and nonclinical samples. Assessment. 2001; 8: 443–454.

[29] Chodkiewicz J, Gruszczyńska E. The Polish adaptation of the suicide behaviors questionnaire-revised by A. Osman et al. Psychiatria Polska. 2020; 54: 101–111.

[30] Rutz W, Knorring L, Pihlgren H, Rihmer Z, Wålinder J. An educa-tional project on depression and its consequences: is the frequency of major depression among Swedish men underrated, resulting in high suicidality? Primary Care Psychiatry. 1995; 1: 59–63.

[31] Chodkiewicz J. Polish adaptation of the Gotland Male Depression Scale (GDMS) by Wolfgang Rutz. Advances in Psychiatry and Neurology. 2017; 26: 13–23.

[32] Nadeau MM, Balsan MJ, Rochlen AB. Men’s depression: endorsed experiences and expressions. Psychology of Men and Masculinity. 2016; 17: 328–335.

[33] Goodwin GM. Depression and associated physical diseases and symptoms. Dialogues in Clinical Neuroscience. 2006; 8: 259–265.

[34] Livneh H, Antonak RF. Psychological adaptation to chronic illness and disability: a primer for counselors. In Marini I, Stebnicki MA. (eds.) The psychological and social impact of illness and disability (pp. 95–107). Springer Publishing Company. 2012.

[35] Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. The American Journal of Psychiatry. 2000; 157: 1552–1562.

[36] Angelini V, Klijs B, Smidt N, Mierau JO. Associations between childhood parental mental health difficulties and depressive symptoms in late adulthood: the influence of life-course socioeconomic, health and lifestyle factors. PLoS ONE. 2016; 11: e0167703.

[37] Loechner J, Starman K, Galuschka K, Tamm J, Schulte-Körne G, Rubel J, et al. Preventing depression in the offspring of parents with depression: a systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review. 2018; 60: 1–14.

[38] Nasser EH, Overholser JC. Recovery from major depression: the role of support from family, friends, and spiritual beliefs. Acta Psychiatrica Scandinavica. 2005; 111: 125–132.

[39] Taylor RJ, Chae DH, Lincoln KD, Chatters LM. Extended family and friendship support networks are both protective and risk factors for major depressive disorder and depressive symptoms among African-Americans and black Caribbeans. The Journal of Nervous and Mental Disease. 2015; 203: 132–140.

[40] van Harmelen A, Gibson JL, St Clair MC, Owens M, Brodbeck J, Dunn V, et al. Friendships and family support reduce subsequent depressive symptoms in at-risk adolescents. PLoS ONE. 2016; 11: e0153715.

[41] Oliffe JL, Ogrodniczuk JS, Gordon SJ, Creighton G, Kelly MT, Black N, et al. Stigma in male depression and suicide: a canadian sex comparison study. Community Mental Health Journal. 2016; 52: 302–310.

[42] Harandi TF, Taghinasab MM, Nayeri TD. The correlation of social support with mental health: a meta-analysis. Electronic Physician. 2017; 9: 5212–5222.

[43] Lund EM, Nadorff MR, Seader K. Relationship between suicidality and disability when accounting for depressive symptomatology. Rehabilitation Counseling Bulletin. 2016; 59: 185–188.

[44] Ribeiro JD, Huang X, Fox KR, Franklin JC. Depression and hopeless-ness as risk factors for suicide ideation, attempts and death: meta-analysis of longitudinal studies. The British Journal of Psychiatry. 2018; 212: 279–286.

[45] Dierker LC, Avenevoli S, Stolar M, Merikangas KR. Smoking and depression: an examination of mechanisms of comorbidity. The American Journal of Psychiatry. 2002; 159: 947–953.

[46] Lyons M, Hitsman B, Xian H, Panizzon MS, Jerskey BA, Santangelo S, et al. A twin study of smoking, nicotine dependence, and major depression in men. Nicotine & Tobacco Research. 2008; 10: 97–108.

[47] Korhonen T, Broms U, Varjonen J, Romanov K, Koskenvuo M, Kinnunen T, et al. Smoking behavior as a predictor of depression among Finnish men and women: a prospective cohort study of adult twins. Cambridge University Press. 2007; 37: 705–715.

[48] Komiyama M, Yamakage H, Satoh-Asahara N, Ozaki Y, Morimoto T, Shimatsu A, et al. Sex differences in nicotine dependency and depressive tendency among smokers. Psychiatry Research. 2019; 267: 154–159.

[49] Mendelsohn CP. Smoking and depression. Australian Family Physi-cian. 2012; 41: 304–307.

[50] Haukkala A, Uutela A, Vartiainen E, McAlister A, Knekt P. Depression and smoking cessation: the role of motivation and self-efficacy. Addictive Behaviors. 2000; 25: 311–316.

[51] Kodriati N, Pursell L, Hayati EN. A scoping review of men, masculinities, and smoking behavior: the importance of settings. Global Health Action. 2018; 11: 1589763.

[52] Siru R, Hulse GK, Tait RJ. Assessing motivation to quit smoking in people with mental illness: a review. Addiction. 2009; 104: 719–733.

[53] Prochaska JJ. Failure to treat tobacco use in mental health and addiction treatment settings: a form of harm reduction? Drug and Alcohol Dependence. 2010; 110: 177–182.

[54] van der Meer RM, Willemsen MC, Smit F, Cuijpers P. Smoking cessation interventions for smokers with current or past depression. The Cochrane Database of Systematic Reviews. 2013; CD006102.

[55] Gierisch JM, Bastian LA, Calhoun PS, McDuffie JR, Williams JW. Smoking cessation interventions for patients with depression: a systematic review and meta-analysis. Journal of General Internal Medicine. 2012; 27: 351–360.

[56] Okoli CTC, Torchalla I, Oliffe JL, Bottorff JL. Men’s smoking cessation interventions: a brief review. Journal of Men’s Health. 2011; 8: 100–108.

[57] Evins AE, Korhonen T, Kinnunen TH, Kaprio J. Prospective asso-ciation between tobacco smoking and death by suicide: competing risks hazard analysis in a large twin cohort with 35-year follow-up. Psychological Medicine. 2017; 47: 2143–2154.

[58] Toftdahl NG, Nordentoft M, Hjorthøj C. Prevalence of substance use disorders in psychiatric patients: a nationwide Danish population-based study. Social Psychiatry and Psychiatric Epidemiology. 2016; 51:129–140.

[59] Yang P, Tao R, He C, Liu S, Wang Y, Zhang X. The risk factors of the alcohol use disorders-through review of its comorbidities. Frontiers in Neuroscience. 2019; 12: 303.

[60] Acheson A, Mahler SV, Chi H, de Wit H. Differential effects of nicotine on alcohol consumption in men and women. Psychopharma-cology. 2006; 186: 54–63.

[61] Hasin DS, Stinson FS, Ogburn E, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry. 2007; 64: 830–842.

[62] Burns L, Teesson M. Alcohol use disorders comorbid with anxiety, depression and drug use disorders. Findings from the Australian national survey of mental health and well being. Drug and Alcohol Dependence. 2002; 68: 299–307.

[63] Lee SB, Chung S, Lee H, Seo JS. The mutual relationship between men’s drinking and depression: a 4-year longitudinal analysis. Alcohol and Alcoholism. 2018; 53: 597–602.

[64] Pavkovic B, Zaric M, Markovic M, Klacar M, Huljic A, Caricic A. Double screening for double disorder, alcoholism and depression. Psychiatry Research. 2018; 270: 483–489.

[65] Bromet EJ, Parkinson DK, Curtis EC, Schulberg HC, Blane H, Dunn LO, et al. Epidemiology of depression and alcohol abuse/dependence in a managerial and professional work force. Journal of Occupational Medicine. 1991; 32: 989–995.

[66] Conner KR, Pinquart M, Gamble SA. Meta-analysis of depression and substance use among individuals with alcohol use disorders. Journal of Substance Abuse Treatment. 2009; 37: 127–137.

[67] Tahmassian K, Jalali Moghadam N. Relationship between self-efficacy and symptoms of anxiety, depression, worry and social avoidance in a normal sample of students. Iranian Journal of Psychiatry and Behavioral Sciences. 2014; 5: 91–98.

[68] Milanovic M, Ayukawa E, Usyatynsky A, Holshausen K, Bowie CR. Self efficacy in depression: bridging the gap between competence and real world functioning. The Journal of Nervous and Mental Disease. 2019; 206: 350–355.

[69] Bartolomucci A, Leopardi R. Stress and depression: preclinical research and clinical implications. PLoS ONE. 2009; 4: e4265.

[70] Charney DS. Psychobiological mechanisms of resilience and vulner-ability: implications for successful adaptation to extreme stress. The American Journal of Psychiatry. 2004; 161: 195–216.

[71] Wermelinger Ávila MP, Lucchetti AL, Lucchetti G. Association between depression and resilience in older adults: a systematic review and meta-analysis. International Journal of Geriatric Psychiatry. 2017; 32: 237–246.

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