Bipolar Disorder in Women

Abstract

The research on gender's role in bipolar disorders has drawn significant interest recently. The presentation and course of bipolar disorder differs between women and men. Women experience depressive episodes, dysphoric mood, mixed states, rapid cycling and seasonal patterns more often than men. Comorbidity, particularly thyroid disease, migraine, obesity, and anxiety disorders laso occur more frequently in women than men. On the other hand men with bipolar disorder are also more likely than women to have problems with drug or alcohol abuse. The pregnancy and postpartum period is a time of high risk for onset and recurrence of bipolar disorder in women. .

Keywords

• Female, gender , bipolar disorder, mania

Kadınlarda Bipolar Bozukluk

Öz

Bipolar bozuklukta cinsiyetin etkisini araştıran çalışmalar son yıllarda giderek artmaktadır. Karma atak ve disforik durumlar, depresif atak, hızlı döngülülük, mevsimsel gidiş, hipotiroidi, migren ve obezite başta olmak üzere bedensel hastalık eştanısı bipolar bozukluğu olan kadınlarda erkeklerden daha sık görülmektedir. Alkol ve madde kullanım bozukluğu eş tanısı erkek bipolar bozukluk olgularında daha sık olmakla birlikte, kadınlarda alkol ve madde kullanım bozukluğu geliştirme riski, erkek bipolar bozukluk olgularına göre daha yüksektir. Bipolar bozukluğu olan kadınlarda iki yaşam dönemi, gebelik ve doğum sonrası dönem, alevlenme ve yinelemeler yönünden özel önem taşımaktadır.

Anahtar Kelimeler

• Kadın, cinsiyet, bipolar bozukluk, mani

Kaynakça

1. Kessing LV. Gender differences in the phenomenology of bipolar disorder. Bipolar Disord 2004; 6(5):421-425.
2. Frye MA, Altshuler LL, McElroy SL, Suppes T, Keck PE, Denicoff K et al. Gender differences in prevalence, risk, and clinical correlates of alcoholism comorbidity in bipolar disorder. Am J Psychiatry 2003; 160:883-889.
3. Baldassano CF, Marangell LB, Gyulai L, Ghaemi SN, Jaffe H, Kim DR et al. Gender differences in bipolar disorder: retrospective data from the first 500 STEPBD participants. Bipolar Disord 2005; 7:465-470.
4. Vega P, Barbeito S, Azua SR, Cengotitabengoa MM, Ortega IG, Saenz M et al. Bipolar disorder differences between genders: special considerations for women. Womens Health (Long Engl) 2011; 7:663-674.
5. Kennedy N, Boydell J, Kalidindi S,Fearon P, Jones P B, van Os J et al. Gender differences in incidence and age at onset of mania and bipolar disorder over a 35-year period in Camberwell, England. Am J Psychiatry 2005; 162:257-262.
6. Benazzi F. Gender differences in bipolar-II disorder. Eur Arch Psychiatry Clin Neurosci 2006; 256:67-71.
7. Brand S, Angst J, Holsboer-Trachsler E. Is the increase of hypomanic stages during adolescence related to gender and developmental tasks? World J Biol Psychiatry 2010; 11:594-602.
8. Miettunen J, Veijola J, Freimer N, Lichtermann D, Peltonen L, Paunio T et al. Data on schizotypy and affective scales are gender and education dependent-study in the Northern Finland 1966 Birth Cohort. Psychiatry Res 2010; 178:408-413.

9. Lieberman DZ, Massey SH, Goodwin FK. The role of gender in single vs married individuals with bipolar disorder. Compr Psychiatry 2010; 51:380-385.
10. Currier D, Mann MJ, Oquendo MA, Galfalvy H, Mann JJ. Sex differences in the familial transmission of mood disorders. J Affect Disord 2006; 95:51-60.
11. Taylor MA, Abrams R. Gender differences in bipolar affective disorder. J Affect Disord 1981; 3:261-271
12. Goldstein JM, Faraone SV, Chen WJ, Tsuang MT. The role of gender in understanding the familial transmission of schizoaffective disorder. Br J Psychiatry 1993; 163:763-768.
13. Yüncü Z, Kesebir S, Akdeniz F, Vahip S. Anticipation in bipolar disorder: a comparison between two generations. Turk Psikiyatri Derg 2008; 19:349-357.
14. Rucci P, Nimgaonkar VL, Mansour H, Miniati M, Masala I, Fagiolini A et al. Gender moderates the relationship between mania spectrum and seratonin transporter polymorphisms in depression. Am J Med Genet B Neuropsychiatr Genet 2009; 150:907-913.
15. Ohadi M, Keikhaee MR, Javanbakht A, Sargozaee MR, Robabeh M, Najmabadi M. Gender dimorphism in the DAT1-67 T-allele homozygosity and predisposition to bipolar disorder. Brain Res 2007; 1144:142-145.
16. Mackey CE, Roddick E, Barrick TR, Lloyd A, Roberts N, Crow TJ et al. Sex dependence of brain size and shape in bipolar disorder: an exploratory study. Bipolar Disord 2010; 12:306-311.
17. Bora E, Fornito A, Yücel M, Pantelis C. The effects of gender on grey matter abnormalities in major psychoses: a comparative voxelwise meta-analysis of schizophrenia and bipolar disorder. Psychol Med 2011; 11:1-13.
18. Almeida JR, Akkal D, Hassel S, Travis MJ, Banihashami L, Kerr N et al. Reduced gray matter volume in ventral prefrontal cortex but not amygdala in bipolar disorder.significant effects of gender and trait anxiety. Psychiatry Res 2009; 171:54
19. Steen NE, Lorentzen S, Barrett EA, Lagerberg TV, Hope S, Larsson S et al. Sexspecific cortisol levels in bipolar disorder and schizophrenia during mental challengerelationship to clinical characteristics and medication. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:1100-1107.
20. Hendrick V, Altshuler LL, Gitlin MJ, Delrahim S, Hammen C. Gender and bipolar illness. J Clin Psychiatry 2000; 61:393-396
21. Arnold LM. Gender differences in bipolar disorder. Psychiatr Clin North Am 2003; 26:595-620.
22. Kessing LV. Gender differences in subtypes of late-onset depression and mania. Int Psychogeriatr 2006; 18:727-738.
23. Kawa I, Carter JD, Joyce PR, Doughty CJ, Frampton CM, Wells JE et al. Gender differences in bipolar disorder: age of onset, course, comorbidity, and symptom presentation. Bipolar Disord 2005; 7:119-125.
24. Nivoli AM, Pacchiarotti I, Rosa AR, Popovic D, Murru A, Valenti M et al. Gender differences in a cohort study of 604 bipolar patients: the role of predominant polarity. J Affect Disord 2011; 133:443-449.
25. Benazzi F. Gender differences in bipolar II and unipolar depressed outpatients: a 557case study. Am Clin Psychiatry 1999; 11:55-59.
26. Burt VK, Rasgon N. Special considerations in treating bipolar disorder in women. Bipolar Disord 2004; 6:2-13.
27. Bhattacharya A, Khess CR, Munda SK, Bakhla AK, Praharaj SK, Kumar M. Sex differience in symptomatology of manic episode. Compr Psychiatry 2011; 52:2882
28. Braunig P, Sarkar R, Effenberger S, Shoofs N, Krüger S. Gender differences in psychotic bipolar mania. Gend Med 2009; 6:356-361.
29. Miquel L, Usall J, Reed C, Bertsch J, Vieta E, Gonzalez-Pinto A et al. Gender differences in outcomes of acute mania: a 12-month follow-up study. Arch Womens Ment Health 2011; 14:107-113
30. Kumar R, Sinha BN, Chakrabarti N, Baruah S, Sinha VK. Gender differences in resolution of mania. Indian J Psychiatry 2000; 42:198-202.
31. Akarsu S, Erdem M, Bolu A, Günay H, Garip B, Ak M et al. Bipolar bozuklukta cinsiyete göre klinik ve sosyodemografik özelliklerin karşılaştırılması. Gülhane Tıp Dergisi 2012; 54:279-283.
32. Gogos A, Joshua N, Rossell SL. Use of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to investigate group and gender differences in schizophrenia and bipolar disorder. Aust N Z J Psychiatry 2010; 44:220-229.
33. Vaskinn A, Sundet K, Simonsen C, Hellvin T, Melle I, Andreassen OA et al. Sex differences in neuropsychological performance and social functioning in schizophrenia and bipolar disorder. Neuropsychology 2011; 25:499-510.
34. Carrus D, Christodoulou T, Hadjulis M, Haldane M, Galea A, Koukopoulos A et al. Gender differences in immediate memory in bipolar disorder. Psychol Med 2010; 40:1349-1355.
35. Gogos A, van den Buuse M, Rossell S. Gender differences in prepulse inhibition(PPI) in bipolar disorder: men have reduced PPI, women have increased PPI. Int J Neuropsychopharmacol 2009; 12(9):1249-1259.
36. Benedetti A, Fagiolini A, Casamassima F , Mian MS, Adamovit A, Musetti M et al. Gender differences in bipolar disorder type 1: a 48-week prospective follow-up of 72 patients treated in an Italian tertiary care center. J Nerv Ment Dis, 2007; 195:93-96. Diflorio A, Jones I. Is sex important? Gender differences in bipolar disorder. Int Rev Psychiatry 2010; 22:437-452.
37. Tadic A, Wagner S, Hoch J, Başkaya Ö, von Cube R, Skaletz C et al. Gender differences in axis I and axis II comorbidity in patients with borderline personality disorder. Psychopathology 2009; 42:257-263.
38. Barnes C, Mitchell P. Considerations in the management of bipolar disorder in women. Aust N Z J Psychiatry 2005; 39(8):662-673.
39. Leibenluft E. Women with bipolar illness: clinical and research issues. Am J Psychiatry 1996; 153:163-173.
40. Altshuler LL, Kupka RW, Hellemann G, Frye MA, Sugar CA, McElroy SL et al. Gender and depressive symptoms in 711 patients with bipolar disorder evaluated prospectively in the Stanley Foundation bipolar treatment outcome network. Am J Psychiatry 2010; 167:708-715.
41. Suominen K, Mantere O, Valtonen H, Arvilommi P, Leppamaki S, Isometsa E. Gender differences in bipolar disorder type I and II. Acta Psychiatr Scand 2009; 120:464-473.
42. Kriegshauser K, Sajatovic M, Jenkins JH, Cassidy KA, Muzina D, Fattal O et al. Gender differences in subjective experience and treatment of bipolar disorder. J Nerv Ment Dis 2010; 198:370-372.
43. Vemuri M, Kenna HA, Wang PW, Ketter TA, Rasgon NL. Gender-specific lipid profiles in patients with bipolar disorder. J Psychiatr Res 2011; 45:1036-1041.
44. Bloch Y, Ratzoni G, Sobol D, Mendlovic S, Gal G, Levkovitz Y. Gender differences in electroconvulsive therapy: a retrospective chart review. J Affect Disord 2005; 84:99-102.
45. Eroğlu MZ, İçbay E, Tamam L. Bir üniversite hastanesi psikiyatri kliniğinde elektrokonvülzif tedavi uygulanan hastaların demografik ve klinik özellikleri. Dicle Tıp Dergisi 2012; 39:371-376. Sermin Kesebir, Doç. Dr.,Erenköy Ruh Sağlığı ve Hastalıkları Hastanesi, İstanbul; Leman İnanç, Dr., Erenköy Ruh Sağlığı ve Hastalıkları Hastanesi, İstanbul; Çiğdem Hazal Bezgin, Dr., Erenköy Ruh Sağlığı ve Hastalıkları Hastanesi, İstanbul; Fatma Cengiz, Dr., Erenköy Ruh Sağlığı ve Hastalıkları Hastanesi, İstanbul. Yazışma Adresi/Correspondence: Sermin Kesebir, Erenköy Ruh Sağlığı ve Hastalıkları Hastanesi, İstanbul, Turkey. E-mail: [e-mail] Yazarlar bu makale ile ilgili herhangi bir çıkar çatışması bildirmemişlerdir. The authors reported no conflict of interest related to this article. Çevrimiçi adresi / Available online at: www.cappsy.org/archives/vol5/no2/ Çevrimiçi yayım / Published online 24 Şubat/February 24, 2013; doi:10.5455/cap.20130514