Gender differences in 4466 mood disorder patients

Background and Objectives

Characteristics of women and men with bipolar disorder (BD) or major depressive disorder (MDD) have been described with inconsistent findings requiring additional assessment.

Methods

We evaluated clinical characteristics in 4466 consecutive, extensively evaluated mood disorder patients (1491 BD, 2975 MDD; 2795 women, 1671 men) using standard bivariate statistics and multivariable logistic regression modeling.

Results

Diagnosis of MDD occurred 2.28- (women) to 1.62- (men) times more than BD, but prevalence of type II BD (BD2) and type I (BD1) did not differ by gender. BD women had more familial mood disorders, early sexual abuse, anxious or cyclothymic temperament, depressive first episodes, depression–[hypo]mania–interval (DMI) and rapid-cycling course, as well as greater %-time depressed in prospective follow-up, with more suicide attempts but fewer suicides than BD men. BD women also showed more co-occurring anxiety disorder, eating disorder and medical comorbidity, including metabolic disorders and cancer, but lower rates of ADHD and substance-abuse than BD men. MDD women experienced more religious activity, sexual abuse, anxious or cyclothymic temperament, co-occurring eating disorder and medical comorbidity as well as less substance-abuse and ADHD than MDD men but did not differ from men in measures of prospective morbidity.

Conclusions

Many characteristics were selectively associated with women with mood disorders, but prospective morbidity was similar by gender except for greater %-time depressed among BD women. Limited ethnic diversity and treatment in specialized centers may affect generalizability of these findings to other settings.