title: Gender differences in the treatment of patients with bipolar disorder: a study of 7354 patients.
abstract: BACKGROUND
  Gender differences in treatment that are not supported by empirical evidence have been reported in several areas of medicine. Here, the aim was to evaluate potential gender differences in the treatment for bipolar disorder.
  
  
  METHODS
  Data was collected from the Swedish National Quality Assurance Register for bipolar disorder (BipoläR). Baseline registrations from the period 2004-2011 of 7354 patients were analyzed. Multiple logistic regression analysis was used to study the impact of gender on interventions.
  
  
  RESULTS
  Women were more often treated with antidepressants, lamotrigine, electroconvulsive therapy, benzodiazepines, and psychotherapy. Men were more often treated with lithium. There were no gender differences in treatment with mood stabilizers as a group, neuroleptics, or valproate. Subgroup analyses revealed that ECT was more common in women only in the bipolar I subgroup. Contrariwise, lamotrigine was more common in women only in the bipolar II subgroup.
  
  
  CONCLUSIONS
  As BipoläR contains data on outpatient treatment of persons with bipolar disorder in Sweden, it is unclear if these findings translate to inpatient care and to outpatient treatment in other countries.
  
  
  CONCLUSIONS
  Men and women with bipolar disorder receive different treatments in routine clinical settings in Sweden. Gender differences in level of functioning, bipolar subtype, or severity of bipolar disorder could not explain the higher prevalence of pharmacological treatment, electroconvulsive therapy, and psychotherapy in women. Our results suggest that clinicians׳ treatment decisions are to some extent unduly influenced by patients׳ gender.
authors.affiliation: Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: alina.karanti@vgregion.se.
authors.forename: Alina
authors.initials: A
authors.lastname: Karanti
authors.affiliation: Statistics and Data Analysis, Department of Computer and Information Science, University of Linköping, Linköping, Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Bobeck
authors.affiliation: Statistics and Data Analysis, Department of Computer and Information Science, University of Linköping, Linköping, Sweden.
authors.forename: Maja
authors.initials: M
authors.lastname: Osterman
authors.affiliation: Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Mathias
authors.initials: M
authors.lastname: Kardell
authors.affiliation: Department of Clinical Neuroscience, Center for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Dag
authors.initials: D
authors.lastname: Tidemalm
authors.affiliation: Department of Clinical Neuroscience, Center for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Runeson
authors.affiliation: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Paul
authors.initials: P
authors.lastname: Lichtenstein
authors.affiliation: Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Landén
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000628:therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004565:Electroconvulsive Therapy; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D018020:Lithium Compounds / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011613:Psychotherapy; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D013548:Sweden; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D018020:Lithium Compounds; D014227:Triazines; D001569:Benzodiazepines; D014635:Valproic Acid; D000077213:Lamotrigine
keywords: Bipolar disorder; Drug therapy; Electroconvulsive therapy; Gender; Psychotherapy