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Suicidal attempts and substance abuse have been related to poor cognitive control (11, 12).Significant sex differences have been found in the cognitive control of emotion (13).

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Despite strong evidence suggesting poor outcomes, male MDD is underrepresented in the extant literature.In terms of other risk factors, social stress is closely related to female MDD, whereas low self-esteem is more likely to be related to male MDD (5).Furthermore, looking after small children is associated with greater risk of MDD in women (6) whereas men are more sensitive to the depressogenic effects of divorce, separation, and occupational problems (7).However, given the lack of previous studies, we conducted whole-brain analysis to identify patterns of task-induced activity and then tested for group-by-sex interactions in those regions.Initially, all participants were investigated, followed by an analysis in male participants alone.Men are more liable to persistent depression whereas women tend to suffer from a more episodic disorder (8).

Depressed men are also more likely to commit suicide (9) and abuse substances (10) than depressed women.

Future research may consider altered developmental trajectories and the possible implications of sex-specific treatment and prevention strategies for MDD.

The incidence of MDD for girls rises from age 11 to 13 years until by age 15 one of the most robust findings in psychiatric epidemiology emerges; that females are twice as likely to suffer from MDD than males (although this predominance might disappear after age 55 years) (1).

To the best of our knowledge, this is the first f MRI study specifically addressing aberrancy in brain activation in males with MDD, and sex differences in cognitive control in adolescents with MDD.

It was hypothesized that there would be a significant sex difference in brain activation associated with cognitive control in the affected group.

Results from the female participants alone have been published elsewhere (38).