Serra-Navarro Maria, Clougher Derek, Oliva Vincenzo, Valenzuela-Pascual Clàudia, De Prisco Michele, Forte María Florencia, Garriga Marina, Solé Brisa, Sánchez-Moreno Jose, Verdolini Norma, Menculini Giulia, Tortorella Alfonso, Bernardo Miquel, Ramos-Quiroga J Antoni, Martinez-Aran Anabel, Vieta Eduard, Amoretti Silvia, Torrent Carla
Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain.
Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, Spain.
Eur Psychiatry. 2025 Mar 5;68(1):e45. doi: 10.1192/j.eurpsy.2025.27.
Impairment in both psychosocial functioning and neurocognition (NC) performance is present in bipolar disorder (BD) yet the role of sex differences in these deficits remains unclear. The present systematic review and meta-analysis examined whether males and females with BD demonstrate differences in psychosocial functioning and NC performance.
The Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases were systematically searched from inception until November 20, 2023.
Twenty studies published between 2005 and 2023 with a total sample size of 2286 patients with BD were included. A random effects meta-analysis revealed a statistically significant result with a small effect (SMD = 0.313) for sex differences in verbal learning and memory as well as visual learning and memory (SMD = 0.263). Females outperformed males in both domains. No significant sex differences were observed for any other NC outcome or psychosocial functioning. High heterogeneity and differences in assessment scales used should be considered when interpreting these findings, given their potential impact on results.
Future research should adopt a more homogenous, standardized approach using longitudinal designs to gain a clearer insight into sex differences in this population. This approach so may increase the use of preventative therapeutic options to address the difficult clinical challenge of reaching cognitive and functional recovery.
双相情感障碍（BD）患者存在心理社会功能和神经认知（NC）表现受损的情况，但性别差异在这些缺陷中的作用仍不清楚。本系统评价和荟萃分析探讨了双相情感障碍男性和女性在心理社会功能和神经认知表现上是否存在差异。
对Cochrane图书馆、EMBASE、PsycINFO、PubMed、Scopus和Web of Science数据库从建库至2023年11月20日进行系统检索。
纳入了2005年至2023年发表的20项研究，总样本量为2286例双相情感障碍患者。随机效应荟萃分析显示，在言语学习和记忆以及视觉学习和记忆方面的性别差异具有统计学意义，效应量较小（标准化均数差[SMD]=0.313）以及视觉学习和记忆方面（SMD=0.263）。在这两个领域中，女性的表现均优于男性。在任何其他神经认知结果或心理社会功能方面未观察到显著的性别差异。在解释这些发现时，应考虑到评估量表使用中的高度异质性和差异，因为它们可能对结果产生影响。
未来的研究应采用更统一、标准化的方法，并采用纵向设计，以更清楚地了解该人群中的性别差异。这种方法可能会增加预防性治疗方案的使用，以应对实现认知和功能恢复这一艰巨的临床挑战。
