Gender differences in bipolar disorder: retrospective data from the first 500 STEP-BD participants.
OBJECTIVE
To examine gender differences in a large sample of patients with bipolar illness.


METHODS
Exploratory analysis of baseline data from the first 500 patients in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a multi-center NIMH project. Participants are allowed to have medical and psychiatric comorbidities, and to enter in any mood state, thus making the population more generalizable than many research cohorts. Diagnoses and history were assessed using structured clinical instruments administered by certified investigators. Given the exploratory nature of these analyses, there is no correction of for multiple comparisons. However, we emphasize findings that are statistically significant at the more stringent p < 0.01 level.


RESULTS
Compared with men, women had higher rates of BPII (15.3% M versus 29.0% F, p < 0.01), comorbid thyroid disease (5.7% M versus 26.9% F, p < 0.01), bulimia (1.5% M versus 11.6% F, p < .0.01) and post-traumatic stress disorder (10.6% M versus 20.9% F, p < 0.01). Women and men had equal rates of history of lifetime rapid cycling and depressive episodes. Men were more likely to have a history of legal problems (36% M versus 17.5% F, p < 0.01).


CONCLUSIONS
Potentially important gender differences in certain illness characteristics were found in our study; however, in contrast to other reports, we did not find higher rates of lifetime depressive episodes or rapid cycling in women. Although our study is limited by its retrospective study design, its results are strengthened by our large sample size and use of structured interviews.
Baldassano
Claudia F
CF
Bipolar Disorders Program, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. cfb@mail.med.upenn.edu
Marangell
Lauren B
LB
Gyulai
Laszlo
L
Ghaemi
S Nassir
SN
Joffe
Hadine
H
Kim
Deborah R
DR
Sagduyu
Kemal
K
Truman
Christine J
CJ
Wisniewski
Stephen R
SR
Sachs
Gary S
GS
Cohen
Lee S
LS
D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology