Menculini Giulia, Steardo Luca, Sciarma Tiziana, D'Angelo Martina, Lanza Laura, Cinesi Gianmarco, Cirimbilli Federica, Moretti Patrizia, Verdolini Norma, De Fazio Pasquale, Tortorella Alfonso
Section of Psychiatry, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Front Psychiatry. 2022 Jun 10;13:926594. doi: 10.3389/fpsyt.2022.926594. eCollection 2022.
Sex differences were demonstrated in bipolar disorders (BD) concerning epidemiological, clinical, and psychopathological characteristics, but consensus is lacking. Moreover, data concerning the influence of sex on treatment response in BD is contrasting. The present cross-sectional study aimed to analyze sex differences in a population of BD subjects, with specific focus on psychopathological features and treatment response.
Subjects diagnosed with BD according to the Diagnostic and Statistical Manual of Mental Disorders, 5th version (DSM-5) were recruited. Socio-demographic and clinical characteristics were collected. The Hamilton Rating Scale for Depression, the Mania Rating Scale (MRS), the brief version of the Temperament Evaluation of Memphis, Pisa and San Diego-Münster version (briefTEMPS-M), and the Barratt Impulsiveness Scale-11 items (BIS-11) were used for psychopathological assessment. Treatment response was appraised with the Alda Scale. We performed bivariate analyses to compare socio-demographic, clinical, and psychopathological characteristics between men and women ( < 0.05). A logistic regression was run to analyze features that were significantly associated with female sex.
Among the recruited 219 BD subjects, 119 (54.3%) were females. Women had a lower scholarity ( = 0.015) and were less frequently employed ( = 0.001). As for psychopathological features, a higher MRS total score ( < 0.001) was detected among women, as well as higher BIS-11 total score ( = 0.040), and briefTEMPS-M score for anxious temperament ( = 0.006). Men showed higher prevalence of DSM-5 mixed features ( = 0.025), particularly during a depressive episode ( = 0.014). Women reported longer duration of untreated illness (DUI) ( < 0.001). There were no sex differences in the Alda Scale total score when considering the whole sample, but this was significantly higher among men ( = 0.030) when evaluating subjects treated with anticonvulsants. At the logistic regression, female sex was positively associated with longer DUI ( < 0.001; OR 1.106, 95% CI 1.050-1.165) and higher MRS total score ( < 0.001; OR 1.085, 95% CI 1.044-1.128) and negatively associated with employment ( = 0.003; OR 0.359, 95% CI 0.185-0.698) and DSM-5 mixed features ( = 0.006; OR 0.391, 95% CI 0.200-0.762).
The clinical presentation of BD may differ depending on sex. The severity of BD should not be neglected among women, who may also display worse treatment response to anticonvulsants.
双相情感障碍（BD）在流行病学、临床和精神病理学特征方面存在性别差异，但尚未达成共识。此外，关于性别对BD治疗反应影响的数据也存在矛盾。本横断面研究旨在分析BD患者群体中的性别差异，特别关注精神病理学特征和治疗反应。
招募根据《精神疾病诊断与统计手册》第5版（DSM-5）诊断为BD的患者。收集社会人口学和临床特征。使用汉密尔顿抑郁评定量表、躁狂评定量表（MRS）、孟菲斯、比萨和圣地亚哥-明斯特气质评估简版（briefTEMPS-M）以及巴拉特冲动性量表-11项（BIS-11）进行精神病理学评估。用阿尔达量表评估治疗反应。我们进行双变量分析以比较男性和女性之间的社会人口学、临床和精神病理学特征（<0.05）。进行逻辑回归分析与女性显著相关的特征。
在招募的219名BD患者中，119名（54.3%）为女性。女性的受教育程度较低（=0.015），就业频率较低（=0.001）。至于精神病理学特征，女性的MRS总分较高（<0.001），BIS-11总分也较高（=0.040），以及焦虑气质的briefTEMPS-M得分较高（=0.006）。男性的DSM-5混合特征患病率较高（=0.025），尤其是在抑郁发作期间（=0.014）。女性报告的未治疗疾病持续时间（DUI）较长（<0.001）。考虑整个样本时，阿尔达量表总分没有性别差异，但在评估接受抗惊厥药物治疗的患者时，男性的该总分显著更高（=0.030）。在逻辑回归中，女性性别与较长的DUI呈正相关（<0.001；OR 1.106，95%CI 1.050-1.165）和较高的MRS总分呈正相关（<0.001；OR 1.085，95%CI 1.
