Gender Differences in Clinical Characteristics and Comorbidities in Bipolar Disorder: a Study from South India
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Gender Differences in Clinical Characteristics and Comorbidities in Bipolar Disorder: a Study from South India Manjunadh Pillai 1,2 & Ravindra Neelakanthappa Munoli 1 & Samir Kumar Praharaj 1 Shripathy M. Bhat 1,3
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Accepted: 30 August 2020/ # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
The clinical features and course of bipolar disorder differ between women and men; however, studies are limited in Indian population. The objective of this study was to identify gender differences in patients with bipolar disorder. This was a cross-sectional, hospital-based observational study conducted over a period of 25 months. The sample consisted of 110 males and 90 females with a diagnosis of bipolar disorder according to ICD-10 Diagnostic Criteria for Research. Socio-demographic and clinical details were collected using semi-structured proforma. All patients were evaluated on Mini International Neuropsychiatric Interview Plus, Presumptive Stressful Life Events Scale and Clinical Global Impression. Sample consisted of 55% men and 45% women. The total number of episodes was similar between genders, however, the number of manic episodes (p = 0.004) was significantly more in males and the number of depressive (p = 0.003) and mixed episodes (p = 0.018) were significantly more in females. Majority of males had first episode of mania, whereas, first episode in females were mostly depressive (p < 0.001). Comorbid physical disorders were seen in 61.1% females and 40% males. Bipolar disorder subtype, episode types and number varied across gender. Co-morbid hypothyroidism, migraine, and obesity are seen more often in women and substance use was higher in men. Keywords Bipolar disorder . Gender differences . Comorbidity
* Samir Kumar Praharaj [email protected]; [email protected]
1
Department of Psychiatry, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, ManipalKarnatakaUdupi, India
2
International Psychiatry Fellowship Doctor, Campus for Ageing and Vitality, Northumberland Tyne and Wear, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
3
Present address: Chaitanya, Anant Nagar HIG, Manipal, Udupi, Karnataka, India
Psychiatric Quarterly
Introduction Bipolar disorder (BD) is almost equally prevalent across gender, however, there are several clinical and epidemiological differences [1]. Some differences such as later age of onset [2], and rapid cycling [3] are reported to occur more frequently among women, whereas, some other differences still remain controversial. The overall course of BD in women may be different than males, which includes, a rapid cycling course [4, 5], more episodes of depression or dysphoric mania [6], a later age of onset [6], more episodes of depression than mania [7], and longer duration of individual episodes of depression [8]. The course of bipolar disorder may be different in developing countries such as India as compared to western countries, with higher rates of manic episodes [9]. There are very few studie
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