MRC Centre for Neuropsychiatric Genetics and Genomics, Department of Psychological Medicine and Neurology, Cardiff University, Heath Park, Cardiff, UK.
Int Rev Psychiatry. 2010;22(5):437-52. doi: 10.3109/09540261.2010.514601.
Sex is clearly important in unipolar mood disorder with compelling evidence that depression is approximately twice as common in women than in men. In the case of bipolar disorder, however, it is widely perceived that the reported equal rate of illness in men and women reflects no important gender distinctions. In this paper we review the literature on gender differences in bipolar illness and attempt to summarize what is known and what requires further study. Despite the uncertainties that remain some conclusions can be drawn. Most studies, but not all, report an almost equal gender ratio in the prevalence of bipolar disorder but the majority of studies do report an increased risk in women of bipolar II/hypomania, rapid cycling and mixed episodes. Important gender distinctions are also found in patterns of co-morbidity. No consistent gender differences have been found in a number of variables including rates of depressive episodes, age and polarity of onset, symptoms, severity of the illness, response to treatment and suicidal behaviour. Unsurprisingly, however, perhaps the major distinction between men and women with bipolar disorder is the impact that reproductive life events, particularly childbirth, have on women with this diagnosis.
性别在单相心境障碍中显然很重要，有确凿证据表明，女性抑郁症的发病率大约是男性的两倍。然而，对于双相情感障碍，人们普遍认为男女发病率相等，这反映了性别之间没有重要的区别。在本文中，我们回顾了双相情感障碍中性别差异的文献，并试图总结已知的和需要进一步研究的内容。尽管仍然存在不确定性，但可以得出一些结论。尽管大多数研究报告称双相情感障碍的患病率男女比例几乎相等，但大多数研究确实报告称女性患双相 II 型/轻躁狂、快速循环和混合发作的风险增加。在合并症模式中也发现了重要的性别差异。在许多变量中，包括抑郁发作的频率、发病年龄和极性、症状、疾病严重程度、治疗反应和自杀行为，没有发现一致的性别差异。然而，也许在双相情感障碍患者中，男性和女性之间的主要区别是生殖生命事件，特别是分娩，对女性的影响。
