Bipolar disorder affects men and women differently, and this may impact the course and treatment of the condition, according to new research published in the Journal of Affective Disorders.
Researchers studied 461 men and 629 women with bipolar I disorder and found that depressive symptoms are more dominant in women with the condition, whereas manic features are more common in men.
The gender difference in symptoms—depression in women and mania in men—is reflected in the first episode of the illness and considered the reason for the longer delay in women receiving a correct diagnosis compared to men. Women also have a higher number of suicide attempts.
Not only are women with bipolar disorder at greater risk for attempting suicide, but they are also more likely than men to have an eating disorder and a specific phobia. On the other hand, men are more likely to have high rates of substance abuse, suggests the study.
The men and women in the study also differed with regard to medical co-morbid conditions, with women more likely to suffer from metabolic disorders and men from neurologic conditions and cancer.
The researchers, led by psychiatrist Dr. Jean-Michel Azorin (Sainte Marguerite Hospital, Marseille, France), suggest that “the differences in psychiatric comorbidity may to a certain extent account for the differences found in medical co-morbidity.”
In fact, “the higher neurologic co-morbidity of bipolar men may be due to their higher co-morbidity with substance abuse,” said the researchers. And the increased risk for co-morbid endocrine and metabolic disorders in bipolar women could be partly explained by their increased prevalence of eating disorders.
“In any event, the differences in medical comorbidity may suggest gender-specific preventive measures,” said the researchers.
Being single, excessive alcohol use, excessive use of substances other than alcohol, presence of mood-congruent psychotic features, and manic polarity at onset were all significantly increased in men with bipolar disorder. On the other hand, depressive and cyclothymic (milder form of bipolar) temperament were significantly decreased in such men.
“The study findings are likely to have several clinical implications, particularly with respect to the risks that may be differentially shared by bipolar women and bipolar men,” the researchers conclude.
Source: Journal of Affective Disorders
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