Special Issues

Abstract

It is well known that concerning the prevalence of unipolar depression, females have almost double rates in comparison to males (Lloyd and Miller 1997 ;Blazer et al. 1994 ). However, this does not hold true concerning BD, for which similar rates between males and females are reported. There are some data suggesting that males might be over-represented in those diagnosed with a BD-I and females overrepresented in those diagnosed with a BD-II disorder (Parker et al. 2014 ).Some authors suggest that females with less social support and experiencing social stressors might be at the greatest risk to develop depression, but this concerns unipolar and not bipolar cases. It has been documented that women are more likely to experience stressful and even threatening life events and are at a higher risk of early sexual abuse and current spousal abuse (Roesler and McKenzie 1994 ;Finkelhor et al. 1990 ). Women also might use oral contraceptive and often experience mood disorders temporally related to their gender identity (e.g. premenstrualor postpartum-onset mood disorders) which might have an impact on the course of BD (Meinhard et al. 2014 ). A number of adverse experiences related to sexual life and determined by gender seem to happen in the lives of bipolar women. In comparison to healthy women, bipolar women might be more likely to have been forced by their partners to have sex, raped or suffering from sexually transmitted diseases. The use of contraceptives is usually sporadic and their rates of pregnancy and abortion are high (Ozcan et al. 2014 ).Also, in almost all societies, unequal roles for women are in place, and additionally there is a gender difference in copying styles; men might react to emotional distress by trying not to think about it, while women are more likely to ruminate over their problems (Nolen-Hoeksema and Girgus 1994 ;Nolen-Hoeksema et al. 1999, 2007. In this frame, women are more likely to report depressive symptoms due to marital problems than men (Joiner et al. 1992 ;Hammen and Peters 1978 ) and are more likely to be diagnosed with depression because they seek professional help more often for their depressive symptoms and maybe because they are more 660 sensitive to negative relationships (Phillips and Segal 1969 ). Concerning the neurocognitive function, the data are inconsistent (Bucker et al. 2014 ;Suwalska and Lojko 2014 ).Overall there does not seem to be any signifi cant gender difference concerning the risk of recurrence, thus suggesting that gender is among the risk factors for initiating depressive symptoms in unipolar depression but not among those determining the course and outcome either in unipolar or in bipolar cases (Nazroo et al. 1997 ;Philibert et al. 1997 ).There are a number of comorbid conditions which seem to be more frequent in bipolar women, including abdominal obesity. This happens possibly because of a higher frequency of predominant depressive polarity in women and more seasonal variations in mood disturbance and reproductive life events and related treatments (Baskara...

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 1: Background and Methods of the Development of Guidelines

“…Since BD is characterized by phases that respond to a completely different way to treatment, it is of outmost importance to define phases of treatment and comorbidity ( Fountoulakis, 2015f ; Vrublevska and Fountoulakis, 2015 ).…”