Sex difference in symptomatology of manic episode

Bhattacharya, Apala; Khess, Christoday Raja Jayant; Munda, Sanjay Kumar; Bakhla, Ajay Kumar; Praharaj, Samir Kumar; Kumar, Manish

doi:10.1016/j.comppsych.2010.06.010

Cited by 17 publications

(10 citation statements)

References 34 publications

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“…This is similar to that reported in a study of chronic major or double depression without psychotic features 19 , even though the average age of females in that study was approximately 15 years younger than that in STOP-PD. Our finding is in contrast to the mixed reports of gender differences in bipolar disorder studies in which females were equally 54 or more likely 55 to be married and had attained a similar 54 or lower education level than males 55 , but males were more often employed 54,55 . In comparison, females with schizophrenia have been found to be married more often than males 56,57 , have either more 58 or a similar amount of education 56 and better work history than males 56,57 .…”

Section: Discussioncontrasting

confidence: 99%

A Gender Analysis of the Study of Pharmacotherapy of Psychotic Depression (STOP-PD)

Deligiannidis

Rothschild

Barton³

et al. 2013

J. Clin. Psychiatry

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Background: Gender differences exist in psychiatric disorders; however gender has not been well studied in psychotic depression. This analysis of the largest clinical trial in psychotic depression examined the effects of age and gender on clinical characteristics and predictors of treatment outcome and treatment-associated changes in body mass index (BMI) and metabolic measures. Methods: Analyses were performed on data from 259 subjects aged 18-93 in the double-blind randomized controlled trial of olanzapine plus sertraline (OLZ/SERT) vs. olanzapine plus placebo (OLZ/PBO) for psychotic depression (STOP-PD). Sociodemographic factors, clinical characteristics, treatment outcome and treatment-associated changes in BMI and metabolic measures were analyzed by gender and age. Results: Female gender was associated with divorced (χ2=5.3, d.f.=1, p=0.03) or widowed (χ2=8.1, d.f.=1, p=<0.01) marital status. Co-morbid anxiety disorders were more common in females than males (χ2=4.9, d.f.=1, p=0.03). Hallucinations(χ2=7.8, d.f.=1, p=0.005) and delusions with disorganization (t-test= −2.10, d.f. =257, p=0.04) were significantly associated with female gender as were higher cholesterol measures( χ2=7.15, d.f.=1, p=0.008).There were no significant interactions between treatment and gender in terms of change in BMI. Gender was not associated with treatment response. Discussion: This is the first analysis of gender and age as predictors of treatment outcome and treatment-associated changes in BMI and metabolic adverse effects in psychotic depression. Gender differences exist in patients with psychotic depression, most notably the presence of hallucinations. Female gender was associated with metabolic measures. Future studies with larger sample sizes may detect small gender differences in treatment outcome and treatment-associated changes in BMI and metabolic measures in psychotic depression.

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Section: Discussioncontrasting

confidence: 99%

A Gender Analysis of the Study of Pharmacotherapy of Psychotic Depression (STOP-PD)

Deligiannidis

Rothschild

Barton³

et al. 2013

J. Clin. Psychiatry

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“…On the basis of previously reported associations with depression, manic symptoms and inflammatory markers, sociodemographics, 33, 34, 35, 36 childhood trauma, 32 lifestyle factors, 6, 13, 14, 15 and disease-related characteristics 6, 16, 17, 18 were selected as covariates. Sociodemographics included age and years of education.…”

Section: Methodsmentioning

confidence: 99%

“…This is important, as these factors are related to inflammatory markers 13, 14, 15, 16, 17, 33, 34 as well as depression with and without manic symptoms. 18, 35, 36 Furthermore, we have explored the additive effect of the different inflammatory markers, which, to our knowledge, no other study has done before.…”

Section: Introductionmentioning

confidence: 99%

The association between immune activation and manic symptoms in patients with a depressive disorder

et al. 2013

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Although recent studies have shown that immunological processes play an important role in the pathophysiology of mood disorders, immune activation may only be present in specific subgroups of patients. Our study aimed to examine whether immune activation was associated with (a) the presence of manic symptoms and (b) the onset of manic symptoms during 2 years of follow-up in depressed patients. Patients with a depressive disorder at baseline (N=957) and healthy controls (N=430) were selected from the Netherlands Study of Depression and Anxiety. Assessments included lifetime manic symptoms at baseline and two-year follow up, as well as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) at baseline. Within depressed patients, immune activation was not related to the presence or absence of lifetime manic symptoms at baseline. However, CRP levels were strongly elevated in depressed men who developed manic symptoms compared with those who did not develop manic symptoms over 2 years (P<0.001, Cohen's d=0.89). IL-6 and TNF-α were also higher in depressed men with an onset of manic symptoms, but this association was not significant. However, we found that the onset of manic symptoms was particularly high in men with multiple elevated levels of inflammatory markers. Depressed men who developed manic symptoms during follow-up had increased immunological activity (especially CRP) compared with depressed men who did not develop manic symptoms. Further research should explore whether a treatment approach focusing on inflammatory processes may be more effective in this specific subgroup of depressed patients.

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“…During manic episodes, fewer women than men report problem behaviors, hyperactivity, or heightened sexual interest (Bhattacharya et al, 2011;Kawa et al, 2005;Young et al, 2007). Women are more likely than men to have more frequent depressive episodes in fall and winter (Baldassano et al, 2005).…”

Section: Gender Differencesmentioning

confidence: 96%

Bipolar Disorder in Women

Miller

Ghadiali

LaRusso

et al. 2014

Health Care for Women International

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This article summarizes research pertinent to the clinical care of women with bipolar disorder. With bipolar disorder, female gender correlates with more depressive symptoms and different comorbidities. There is a high risk of symptom recurrence postpartum and possibly during perimenopause. Women with bipolar disorder have increased risk of sexually transmitted diseases, unplanned pregnancies, excessive weight gain, metabolic syndrome, and cardiovascular disease. Mood stabilizing medications, specific psychotherapies, and lifestyle changes can stabilize mood and improve functioning. Pharmacologic considerations include understanding interactions between mood stabilizing medications and contraceptive agents and risks and benefits of mood stabilizing medication during pregnancy and lactation.

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Sex difference in symptomatology of manic episode

Cited by 17 publications

References 34 publications

A Gender Analysis of the Study of Pharmacotherapy of Psychotic Depression (STOP-PD)

A Gender Analysis of the Study of Pharmacotherapy of Psychotic Depression (STOP-PD)

The association between immune activation and manic symptoms in patients with a depressive disorder

Bipolar Disorder in Women

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