ReviewSex differences in anxiety and depression clinical perspectives

•We review sex differences in clinical features of depression and anxiety disorders.•A developmental perspective provides the timing of emergence of sex differences in affective disorders.•The impact of puberty, the menstrual cycle, pregnancy and menopause on anxiety and depression disorders is reviewed.•The impact of sex-specific cultural demands and experiences on development of anxiety and depression disorders is examined.•The interaction of stress with development of sex differences is discussed.

Sex differences are prominent in mood and anxiety disorders and may provide a window into mechanisms of onset and maintenance of affective disturbances in both men and women. With the plethora of sex differences in brain structure, function, and stress responsivity, as well as differences in exposure to reproductive hormones, social expectations and experiences, the challenge is to understand which sex differences are relevant to affective illness. This review will focus on clinical aspects of sex differences in affective disorders including the emergence of sex differences across developmental stages and the impact of reproductive events. Biological, cultural, and experiential factors that may underlie sex differences in the phenomenology of mood and anxiety disorders are discussed.