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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0641

The gender gap in expert opinions is a difference arising from diagnostic composition: seven years of structured psychiatric expert assessment in a pension system

THE SEX GAP IN EXPERT OPINIONS IS A GAP IN DIAGNOSTIC COMPOSITION: SEVEN YEARS OF STRUCTURED PSYCHIATRIC EXPERT EVALUATION IN A PENSION SYSTEM

The lower rate of favorable opinions for women than for men stems not from the differential application of expert assessment criteria by gender, but from the diagnostic and age composition of the cases referred for assessment.

The study examined whether the gender gap in psychiatric disability outcomes in a single expert’s caseload within the Chilean pension system reflected different expert assessment criteria or the composition of the cases reaching assessment. A total of 568 assessments commissioned by Medical Commissions between 2019 and 2025 were analyzed, using March as the index month each year. ICD-10 diagnoses were grouped into common mental disorders (F32, F33, F40–F43), severe mental disorders (F20–F29, F31), neurodevelopmental disorders (F84, F70–F79), personality disorders (F60, F61), and substance use disorders (F10–F19). After excluding 12 cases that could not be classified into these groups, favorable opinions were modeled in 556 assessments using logistic regression based on recorded gender, both unadjusted and adjusted for diagnostic group and age. The favorable opinion rate was 40% for women and 63% for men, with an unadjusted odds ratio (OR) for men of 2.59 (95% confidence interval [CI], 1.82–3.67). After adjustment for diagnostic group and age, the difference was no longer detectable (OR 1.18; 95% CI, 0.70–1.99), and no interaction between gender and diagnostic group was found (p=0.82). Within-group rates for women/men were 89%/90% for severe mental disorders, 100%/98% for neurodevelopmental disorders, and 18%/24% for common mental disorders. Women had a mean age of 50, and 61% had common mental disorders, whereas men had a mean age of 40, and 53% had severe mental or neurodevelopmental disorders (94% received favorable opinions in this group; 62% were under 30). In the modal profile, which accounted for 33% of the series (women over 45 with common mental disorders), only 17% received favorable opinions. The pre-retirement age window (55–60 for women and 60–65 for men) accounted for 22% of assessments; 79% of these involved common mental disorders, and 25% resulted in favorable opinions. The authors state that the gender gap in this caseload reflected its diagnostic and age composition, with no detectable residual effect of gender. However, this study design could not determine whether that composition arose from gender-related differences in diagnosis at earlier stages. They emphasize that applying the same criterion to two different populations produces different outcomes, and that the question of social protection for people who cannot work but do not meet disability criteria remains unresolved.

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