Gender differences in the clinical course of depression in bipolar disorder

Objective: to investigate gender differences in patients with depression and bipolar disorder (BD) and their impact on the clinical course of the disease.Patients and methods. 50 women and 50 men with bipolar disorder (BD) (F31 according to the International Classification of Diseases, 10th revision...

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Main Authors: N. A. Tyuvina, A. E. Stolyarova, D. V. Morozova, M. S. Verbitskaya
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2021-04-01
Series:Неврология, нейропсихиатрия, психосоматика
Subjects:
Online Access:https://nnp.ima-press.net/nnp/article/view/1539
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author N. A. Tyuvina
A. E. Stolyarova
D. V. Morozova
M. S. Verbitskaya
author_facet N. A. Tyuvina
A. E. Stolyarova
D. V. Morozova
M. S. Verbitskaya
author_sort N. A. Tyuvina
collection DOAJ
description Objective: to investigate gender differences in patients with depression and bipolar disorder (BD) and their impact on the clinical course of the disease.Patients and methods. 50 women and 50 men with bipolar disorder (BD) (F31 according to the International Classification of Diseases, 10th revision – ICD-10) were examined using a specially developed survey. Patients symptoms was assessed in  accordance with the diagnostic criteria of affective disorders  according to ICD-10 and DSM-V, MADRS (Montgomery-Asberg  Depression Rating Scale) and Q-LES-Q-SF (Scoring the Quality of Life Enjoyment and Satisfaction Questionnaire).  Results and discussion. Gender differences in the clinical  course of BP were revealed. In men the disease usually starts  with a mania phase followed by a marked mood increase in BD- I, a shorter period before the first mania (hypomania) if the  onset is with the depression phase, mood swings and substance use disorders in puberty, which makes the diagnosis easier. In  women BD diagnosis may be harder due to higher frequency of BD-II, clinical presentation with depression, longer period  before the first mania (hypomania). Therefore the most  important clinical markers of BD in women include the early  onset of the disease, its association with neurohormonal factors,  history of affective variability, substance use disorders, schizophrenia, hereditary or comorbid eating disorder in  puberty or later in life. The most common clinical features  during the depression phase in men include: seasonal fluctuation (worsening of symptoms in autumn and winter) and diurnal variations (improvement of symptoms in the evening), numbed emotions, depersonalization-derealization syndrome, decreased libido, difficulty in falling asleep and increased appetite and/or body mass, comorbid depression, panic attacks and alcohol and substance abuse. The depression in women with BD is characterized by a higher prevalence of apathy, tearfulness, self-harm, body dysmorphic disorder, decreased appetite. Both male and female patients with depression and BD have a high level of anxiety, presence of psychomotor retardation, self-accusation and irritancy, 10% had atypical features according to the DSM-V criteria. Women have a higher proportion of depressive episodes (including rapid cycling BD) and a higher risk of suicidal behavior, and men, due to a higher frequency of manic phases, change partners and have a history of divorce significantly more often.Conclusion. The revealed features of psychopathological  symptoms, comorbid disorders, the course of the disease and  correlations between individual characteristics and factors due  to gender differences, can be used as markers of bipolarity,  which will allow to diagnose BD earlier and more accurately and prescribe adequate therapy.
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spelling doaj.art-a4630df92a6f45b880cb2fcb893518952023-03-13T08:42:20ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422021-04-01132475510.14412/2074-2711-2021-2-47-551111Gender differences in the clinical course of depression in bipolar disorderN. A. Tyuvina0A. E. Stolyarova1D. V. Morozova2M. S. Verbitskaya3Department of Psychiatry and Narcology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaDepartment of Psychiatry and Narcology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaDepartment of Psychiatry and Narcology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaDepartment of Psychiatry and Narcology, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaObjective: to investigate gender differences in patients with depression and bipolar disorder (BD) and their impact on the clinical course of the disease.Patients and methods. 50 women and 50 men with bipolar disorder (BD) (F31 according to the International Classification of Diseases, 10th revision – ICD-10) were examined using a specially developed survey. Patients symptoms was assessed in  accordance with the diagnostic criteria of affective disorders  according to ICD-10 and DSM-V, MADRS (Montgomery-Asberg  Depression Rating Scale) and Q-LES-Q-SF (Scoring the Quality of Life Enjoyment and Satisfaction Questionnaire).  Results and discussion. Gender differences in the clinical  course of BP were revealed. In men the disease usually starts  with a mania phase followed by a marked mood increase in BD- I, a shorter period before the first mania (hypomania) if the  onset is with the depression phase, mood swings and substance use disorders in puberty, which makes the diagnosis easier. In  women BD diagnosis may be harder due to higher frequency of BD-II, clinical presentation with depression, longer period  before the first mania (hypomania). Therefore the most  important clinical markers of BD in women include the early  onset of the disease, its association with neurohormonal factors,  history of affective variability, substance use disorders, schizophrenia, hereditary or comorbid eating disorder in  puberty or later in life. The most common clinical features  during the depression phase in men include: seasonal fluctuation (worsening of symptoms in autumn and winter) and diurnal variations (improvement of symptoms in the evening), numbed emotions, depersonalization-derealization syndrome, decreased libido, difficulty in falling asleep and increased appetite and/or body mass, comorbid depression, panic attacks and alcohol and substance abuse. The depression in women with BD is characterized by a higher prevalence of apathy, tearfulness, self-harm, body dysmorphic disorder, decreased appetite. Both male and female patients with depression and BD have a high level of anxiety, presence of psychomotor retardation, self-accusation and irritancy, 10% had atypical features according to the DSM-V criteria. Women have a higher proportion of depressive episodes (including rapid cycling BD) and a higher risk of suicidal behavior, and men, due to a higher frequency of manic phases, change partners and have a history of divorce significantly more often.Conclusion. The revealed features of psychopathological  symptoms, comorbid disorders, the course of the disease and  correlations between individual characteristics and factors due  to gender differences, can be used as markers of bipolarity,  which will allow to diagnose BD earlier and more accurately and prescribe adequate therapy.https://nnp.ima-press.net/nnp/article/view/1539depressionbipolar disordergendersexdepression in womendepression in men
spellingShingle N. A. Tyuvina
A. E. Stolyarova
D. V. Morozova
M. S. Verbitskaya
Gender differences in the clinical course of depression in bipolar disorder
Неврология, нейропсихиатрия, психосоматика
depression
bipolar disorder
gender
sex
depression in women
depression in men
title Gender differences in the clinical course of depression in bipolar disorder
title_full Gender differences in the clinical course of depression in bipolar disorder
title_fullStr Gender differences in the clinical course of depression in bipolar disorder
title_full_unstemmed Gender differences in the clinical course of depression in bipolar disorder
title_short Gender differences in the clinical course of depression in bipolar disorder
title_sort gender differences in the clinical course of depression in bipolar disorder
topic depression
bipolar disorder
gender
sex
depression in women
depression in men
url https://nnp.ima-press.net/nnp/article/view/1539
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AT aestolyarova genderdifferencesintheclinicalcourseofdepressioninbipolardisorder
AT dvmorozova genderdifferencesintheclinicalcourseofdepressioninbipolardisorder
AT msverbitskaya genderdifferencesintheclinicalcourseofdepressioninbipolardisorder