Citation

Nivoli AMA, Pacchiarotti I, Rosa AR, Popovic D, Murru A, Valentí M, Bonnín CM, Grande I, Sánchez-Moreno J, Vieta E, Colom F. J. Affect. Disord. 2011; 133(3): 443-449.

Copyright

(Copyright © 2011, Elsevier Publishing)

DOI

10.1016/j.jad.2011.04.055

PMID

21620480

Abstract

BACKGROUND: Some clinical differences between gender regarding the course and outcome of bipolar disorders have already been described and some others remain still controversial.
AIMS: To explore gender differences regarding clinical and socio-demographic characteristics amongst bipolar patients with particular attention to predominant polarity and depressive symptoms.
METHOD: Data were collected from DSM-IV type I and II bipolar patients (n=604), resulting from the systematic follow-up of the Bipolar Disorders Program, Hospital Clinic of Barcelona, over an average follow-up of 10 years. Socio-demographic and clinical variables were collected in order to detect gender-related differences.
RESULTS: Bipolar women are more likely than men to show a predominance of depressive polarity as well as a depressive onset whilst men would be more likely to suffer from comorbid substance use disorders. Women significantly have a higher lifetime prevalence of psychotic depression and a higher prevalence of axis II comorbid disorders. Bipolar women are also more likely to have a family history of suicide and a lifetime history of attempted suicide. Suicide attempts are more often violent amongst bipolar men. In a backward logistic regression model, two variables were responsible for most gender-related clinical differences: type of predominant polarity - more likely to be depressive amongst women - (B=-0.794, p=0.027, Exp(B)=0.452; CI= 0.223-0.915), alcohol abuse (B=-1.095, p=0.000, Exp(B)=2990; CI= 1.817-4.919) and cocaine abuse (B=0.784, p=0.033, Exp(B)=2.189; CI= 1.066-4.496) - more prevalent amongst men.
CONCLUSION: The main characteristic featuring bipolar women is depression, both at illness onset and as a predominant polarity all along the illness course. This may have important diagnostic and therapeutic implications.

Language: en

Keywords

Humans; Adult; Female; Male; Middle Aged; Depression; Suicide; Sex Factors; Substance-Related Disorders; Comorbidity; Cohort Studies; Suicide, Attempted; Follow-Up Studies; Diagnostic and Statistical Manual of Mental Disorders; Alcoholism; Depressive Disorder; Bipolar Disorder; Depressive Disorder, Major