Gender does not affect pediatric bipolar I disorder presentation
medwireNews: US researchers have found that girls and boys with pediatric bipolar I disorder have similar clinical presentations, and that the disorder is equally familial in both gender.
"Clinicians should consider bipolar disorder in the differential diagnosis of both boys and girls afflicted with symptoms suggestive of this disorder," they comment in the Journal of Affective Disorders.
Although there were more similarities than differences in the presentation of the disorder in boys and girls, some important differences were noted.
The study, of 239 probands with a diagnosis of bipolar I disorder aged between 6 and 17 years (average age 10.7 years) and 726 first-degree relatives, revealed that girls had a significantly older age at onset of the disorder than boys. They also had a significantly higher rate of panic disorder and tended to have more substance use disorders, although this result did not reach statistical significance.
There was a trend toward the duration of mania being shorter in females, who also tended to have more depressive episodes.
Sixty percent of girls showed symptoms of hypersexuality, whereas the rate in boys was 40%. Joseph Biederman (Massachusetts General Hospital, Boston, USA) and co-authors note: "Hypersexuality when coupled with the recklessness and poor judgment of [bipolar I] disorder can result in increased vulnerability to traumatic experiences, further complicating an already compromised developmental course of this highly morbid disorder."
Girls with bipolar I disorder were more likely to receive extra academic help than boys, with 92% compared with 89% getting help. By contrast, boys were twice as likely as girls to repeat a grade at school and to be placed in a special class. The authors say that "the reason for this remains unclear and might represent a difference in the manifestation of symptoms in the school arena or a bias against retaining girls or placing them in separate classes."
A diagnosis of bipolar I disorder in a proband was found to be a significant predictor of the presence of the disorder in their relatives, and this was irrespective of the gender of the proband.
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By Afsaneh Gray, medwireNews Reporter