Alina Karanti1, Christian Bobeck2, Maja Osterman2, Mathias Kardell3, Dag Tidemalm4, Bo Runeson4, Paul Lichtenstein5, Mikael Landén6. 1. Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address: alina.karanti@vgregion.se. 2. Statistics and Data Analysis, Department of Computer and Information Science, University of Linköping, Linköping, Sweden. 3. Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4. Department of Clinical Neuroscience, Center for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden. 5. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 6. Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Abstract
BACKGROUND: Gender differences in treatment that are not supported by empirical evidence have been reported in several areas of medicine. Here, the aim was to evaluate potential gender differences in the treatment for bipolar disorder. METHODS: Data was collected from the Swedish National Quality Assurance Register for bipolar disorder (BipoläR). Baseline registrations from the period 2004-2011 of 7354 patients were analyzed. Multiple logistic regression analysis was used to study the impact of gender on interventions. RESULTS: Women were more often treated with antidepressants, lamotrigine, electroconvulsive therapy, benzodiazepines, and psychotherapy. Men were more often treated with lithium. There were no gender differences in treatment with mood stabilizers as a group, neuroleptics, or valproate. Subgroup analyses revealed that ECT was more common in women only in the bipolar I subgroup. Contrariwise, lamotrigine was more common in women only in the bipolar II subgroup. LIMITATIONS: As BipoläR contains data on outpatient treatment of persons with bipolar disorder in Sweden, it is unclear if these findings translate to inpatient care and to outpatient treatment in other countries. CONCLUSIONS: Men and women with bipolar disorder receive different treatments in routine clinical settings in Sweden. Gender differences in level of functioning, bipolar subtype, or severity of bipolar disorder could not explain the higher prevalence of pharmacological treatment, electroconvulsive therapy, and psychotherapy in women. Our results suggest that clinicians׳ treatment decisions are to some extent unduly influenced by patients׳ gender.
BACKGROUND: Gender differences in treatment that are not supported by empirical evidence have been reported in several areas of medicine. Here, the aim was to evaluate potential gender differences in the treatment for bipolar disorder. METHODS: Data was collected from the Swedish National Quality Assurance Register for bipolar disorder (BipoläR). Baseline registrations from the period 2004-2011 of 7354 patients were analyzed. Multiple logistic regression analysis was used to study the impact of gender on interventions. RESULTS:Women were more often treated with antidepressants, lamotrigine, electroconvulsive therapy, benzodiazepines, and psychotherapy. Men were more often treated with lithium. There were no gender differences in treatment with mood stabilizers as a group, neuroleptics, or valproate. Subgroup analyses revealed that ECT was more common in women only in the bipolar I subgroup. Contrariwise, lamotrigine was more common in women only in the bipolar II subgroup. LIMITATIONS: As BipoläR contains data on outpatient treatment of persons with bipolar disorder in Sweden, it is unclear if these findings translate to inpatient care and to outpatient treatment in other countries. CONCLUSIONS:Men and women with bipolar disorder receive different treatments in routine clinical settings in Sweden. Gender differences in level of functioning, bipolar subtype, or severity of bipolar disorder could not explain the higher prevalence of pharmacological treatment, electroconvulsive therapy, and psychotherapy in women. Our results suggest that clinicians׳ treatment decisions are to some extent unduly influenced by patients׳ gender.
Authors: Rajapillai L I Pillai; Elizabeth A Bartlett; Mala R Ananth; Chencan Zhu; Jie Yang; Greg Hajcak; Ramin V Parsey; Christine DeLorenzo Journal: Neuroimage Date: 2020-03-10 Impact factor: 6.556
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Authors: J Song; S E Bergen; A Di Florio; R Karlsson; A Charney; D M Ruderfer; E A Stahl; K D Chambert; J L Moran; K Gordon-Smith; L Forty; E K Green; I Jones; L Jones; E M Scolnick; P Sklar; J W Smoller; P Lichtenstein; C Hultman; N Craddock; M Landén; Jordan W Smoller; Roy H Perlis; Phil Hyoun Lee; Victor M Castro; Alison G Hoffnagle; Pamela Sklar; Eli A Stahl; Shaun M Purcell; Douglas M Ruderfer; Alexander W Charney; Panos Roussos; Carlos Pato Michele Pato; Helen Medeiros; Janet Sobel; Nick Craddock; Ian Jones; Liz Forty; Arianna Di Florio; Elaine Green; Lisa Jones; Katherine Gordon-Smith; Mikael Landen; Christina Hultman; Anders Jureus; Sarah Bergen; Steven McCarroll; Jennifer Moran; Jordan W Smoller; Kimberly Chambert; Richard A Belliveau Journal: Mol Psychiatry Date: 2015-10-27 Impact factor: 15.992