REVIEW   

Minerva Psychiatry 2022 June;63(2):69-78

DOI: 10.23736/S2724-6612.22.02300-4

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Gender implications in the seasonal pattern of bipolar disorder: a systematic review

Paula GARCÍA VÁZQUEZ ¹, Antonio SERRANO GARCÍA ¹, Carmen VILELLA MARTÍN ¹, Clara M. FRANCH PATO ¹, Manon MORENO ², Luis GUTIÉRREZ-ROJAS ³ ✉

¹ Department of Psychiatry, Hospital of León, León, Spain; ² Health Research Institute, Jiménez Díaz Foundation, Madrid, Spain; ³ Department of Psychiatry, Institute of Neurosciences, University of Granada, Granada, Spain

INTRODUCTION: The seasonal pattern (SP) of bipolar disorder (BD) has been accepted with its clinical, diagnostic, therapeutic and prognostic consequences. It is interesting to study its epidemiological characteristics, such as the influence of gender on this pattern. Little research has been done in this regard thus missing the impact it could have.
EVIDENCE ACQUISITION: A systematic review was carried out employing a bibliographic search in PubMed, PsycINFO, and Web of Science. After a selection process, 7 studies were included in the review. All articles studied the gender influence in participants with SP of BD. This systematic review aims to clarify the impact of gender and seasonality on BD and evaluate the clinical differences based on gender.
EVIDENCE SYNTHESIS: The initial search showed a total of 96 articles, 7 of which met the inclusion criteria. Women present SP associated with manic, depressive, or mixed episodes; however, men predominately present depressive episodes. Men are more often associated with BD type II and depressive episodes whereas women with rapid cycling and eating disorders. Male manic episodes are associated with psychotic symptoms with greater severity in admissions. Women appear to have a higher risk of SP than men, with the clinical and prognostic repercussions that this entails.
CONCLUSIONS: The diagnosis of the SP in BD continues to be a fundamental challenge. It was found that gender influences both the clinical characteristics and the course, management, and prognosis of bipolar disorders seasonality.

KEY WORDS: Seasons; Bipolar disorder; Gender