title: Gender differences in bipolar disorder type I and II.
abstract: OBJECTIVE
  We investigated gender differences in bipolar disorder (BD) type I and II in a representative cohort of secondary care psychiatric in- and out-patients.
  
  
  METHODS
  In the prospective, naturalistic Jorvi Bipolar Study of 191 secondary care psychiatric in- and out-patients, 160 patients (85.1%) could be followed up for 18 months with a life chart.
  
  
  RESULTS
  After adjusting for confounders, no marked differences in illness-related characteristics were found. However, female patients with BD had more lifetime comorbid eating disorders (P < 0.001, OR = 5.99, 95% CI 2.12-16.93) but less substance use disorders (P < 0.001, OR = 0.29, 95% CI 0.16-0.56) than males. Median time to recurrence after remission was 3.1 months longer among men than women, female gender carrying a higher hazard of recurrence (P = 0.006, HR = 2.00, 95% CI 1.22-3.27).
  
  
  CONCLUSIONS
  Men and women with type I and II BD have fairly similar illness-related clinical characteristics, but their profile of comorbid disorders may differ significantly, particularly regarding substance use and eating disorders. In medium-term follow-up, females appear to have a higher hazard of recurrence than males.
authors.affiliation: Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Suominen
authors.forename: O
authors.initials: O
authors.lastname: Mantere
authors.forename: H
authors.initials: H
authors.lastname: Valtonen
authors.forename: P
authors.initials: P
authors.lastname: Arvilommi
authors.forename: S
authors.initials: S
authors.lastname: Leppämäki
authors.forename: E
authors.initials: E
authors.lastname: Isometsä
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control* / Q000523:psychology; D015897:Comorbidity; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D012008:Recurrence; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult