Does the clinical picture of bipolar disorder in the pediatric population depend on sex?

J Affect Disord. 2024 Oct 15:363:501-506. doi: 10.1016/j.jad.2024.07.071. Epub 2024 Jul 17.

Abstract

Background: In the current literature the influence of sex on the clinical presentation of the bipolar disorder (BD) in adults has been indicated. It was of the interest whether such a phenomenon is also present in the pediatric population.

Methods: The authors collected retrospective clinical data in 288 patients hospitalized on the psychiatry ward aged 10-17 years; 80.2 % females and 19.8 % males.

Results: No sex differences were observed in the age of onset, the time from the onset of symptoms to the diagnosis of BD, the number of symptoms during hospital stay, or family history of psychiatric disorder (U Mann-Whitney's p > 0.05). In males the most frequently recorded first episode of BD was mania or hypomania (51 %), and in females, a depressive episode (51 %). The main reason for the hospitalization in boys was episodes of mania (63 %), then mixed episodes (30 %), and depression (7 %). Whereas girls were most often hospitalized due to mixed episodes (52 %), less frequently depression (22 %), and mania (26 %). Co-morbid psychiatric disorders were found more often in boys than in girls (63 % vs 45 %; χ2p-value>0.05). The co-occurrence of the dissocial personality, borderline, tic disorders, pervasive developmental disorders and hyperkinetic disorders was different in both sexes.

Limitations: The main limitations of the study are the very high proportion of female subjects and the retrospective character of the study.

Conclusions: It seems that the clinical presentation of BD in the pediatric population can somewhat depend on the sex of the patients.

Keywords: Bipolar disorder; Pediatric; Sex.

MeSH terms

  • Adolescent
  • Age of Onset
  • Bipolar Disorder* / epidemiology
  • Child
  • Comorbidity*
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Mania / epidemiology
  • Retrospective Studies
  • Sex Factors