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However, the understanding of its clinical presentation remains highly limited. Here, we tested mental health burden in patients with high masculine depression scores in a case-control study of 163 depressed in-patients (44% women and 56% men; high vs. low masculine depression scores according to a sex-separated median split of the Male Depression Risk Scale-22 [MDRS-22]) and 176 controls (51% women and 49% men). In models adjusted for depression severity, the group of patients with a high masculine depression score (compared to those with a low score) was related to a greater acute mental health burden as measured by the Symptom Checklist-90-Revised (SCL-90-R). This association was evident across the three global indices of the SCL-90-R. Moreover, the dimensions somatization, anger-hostility, paranoid ideation, and psychoticism were associated with the group of patients with high masculine depression scores relative to the group of patients with low masculine depression scores as well as to higher MDRS-22 scores. Here, we provide evidence that patients with high masculine depression scores experience a substantial mental health burden \u2013 regardless of their biological sex. This is important, as patients with masculine depression were shown to be undertreated.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial registration<\/jats:bold>\n                    German Clinical Trials Register ID DRKS00015291, Registration Date 2020-01-06.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-44727-7","type":"journal-article","created":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T10:34:56Z","timestamp":1775385296000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Masculine depression and acute mental health burden"],"prefix":"10.1038","volume":"16","clinical-trial-number":[{"clinical-trial-number":"drks00015291","registry":"10.18810\/drks"}],"author":[{"given":"Claudia","family":"von Zimmermann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Weinland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kornhuber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"Lenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"M\u00fchle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,5]]},"reference":[{"issue":"8948","key":"44727_CR1","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/S0140-6736(95)90622-3","volume":"345","author":"W Rutz","year":"1995","unstructured":"Rutz, W. et al. 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It has been registered in the German Clinical Trials Register (ID DRKS00015291, Registration Date 2020-01-06).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and study registration"}},{"value":"All study participants provided informed consent. The study was conducted in accordance with the Declaration of Helsinki after review and approval by the Ethics Committee of the Medical Faculty of the FAU.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"During the preparation of this work, the author(s) used ChatGPT (OpenAI, San Francisco, CA, USA) in order to improve the language and clarity of the manuscript. After using this tool, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the published article.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration of generative AI and AI-assisted technologies in the manuscript preparation process"}}],"article-number":"11606"}}