The benefits of marriage appear to be greater for women with bipolar disorder than for men with the disorder, US researchers report.

They note, however, that the extra benefit in women was limited to a reduction in depressive symptoms.

“Mental illnesses in general are responsive to varying levels of social support, and women appear to react more strongly to these variations than men do,” say Daniel Lieberman and colleagues from George Washington University School of Medicine and Health Sciences.

“The interpersonal and social rhythm therapy literature also suggest that women may benefit more from the increased lifestyle regularity that can be seen in stable marriages.”

The researchers used the National Institute of Mental Health Life Chart Methodology to collect data on episodes of depression, mania, and mixed states from the previous 2 years for 282 individuals (71 men and 211 women) with bipolar disorder.

In all, 28 (39%) of the men and 112 (53%) of the women were married, indicating that women with bipolar disorder were significantly more likely to be married than men with the condition. The remaining study participants had never been married.

Married women had fewer episodes of depression during the past 2 years than never-married women, at 6.1% versus 7.3%, and the cumulative severity of depression was lower, with average depression scores of 11.7 versus 14.5.

Married and unmarried women with bipolar disorder did not differ with regard to diagnostic subtype or age of onset, however.

By contrast, among men, bipolar I disorder was more common among those who had never been married (n=22 versus 9), and unmarried men had an earlier age at onset of bipolar disorder than their married peers (13.6 versus 20.2 years).

But there was no difference between married and unmarried men with bipolar disorders in terms of frequency, duration, or severity of mood episodes.

The researchers suggest in the journal Comprehensive Psychiatry that the gender differences in their study may be the “result of potential male spouses placing less weight on bipolar disorder as a selection factor or the illness manifesting itself differently in men and women.”

They conclude: “The finding that women with bipolar disorder may be more sensitive to the benefits of being married than men may be helpful in understanding bipolar disorder in men and women and in developing effective treatment strategies.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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People who care for bipolar disorder (BD) patients with increasing suicidal ideation (SI) over time and depressive, rather than manic, symptoms are prone to suffering from depression and worsening health, show US researchers.

“Our study results may help to prospectively identify caregivers at risk for adverse health outcomes who may benefit from prevention-focused intervention,” say Cheryl Chessick (University of Colorado Denver School of Medicine) and co-authors.

For the study, the team evaluated 500 patients participating in the Systematic Treatment Enhancement Program for Bipolar Disorder ??” a multicenter study evaluating the course and outcome of patients with BD ??” and their primary caregivers (including 188 parental and 182 spousal) for up to 1 year.

Caregivers’ perceptions of their own physical health and depression were evaluated using the general health scale from the Medical Outcomes Study 36-item Short-Form Health Survey and the Center for Epidemiological Studies of Depression Scale, respectively.

After controlling for patient’s history of suicide attempts, education, baseline Global Assessment of Functioning scores, current alcohol or substance abuse, and living situation, higher SI scores at baseline and at 6 and 12 months were associated with lower caregiver health scores at all time points compared with patients who had lower SI scores at all times.

Furthermore, poorer caregiver health at 6 and 12 months was significantly associated with caring for patients who showed increased SI at 6 and/or 12 months compared with baseline. This association remained significant after controlling for confounding factors.

In contrast, patients’ depression scores at all time points were not significantly related to caregivers’ self-reported health. “Thus, SI appears to have contributed to caregivers’ health, whereas depression in the absence of SI did not,” remark the researchers.

Caregivers were more likely to have higher depression scores at all time points if they were caring for patients with higher SI at all follow-up points compared with caregivers of patients with lower SI, after controlling for confounding factors.

However, the increase in patients’ SI from baseline was not significantly associated with caregivers’ depression scores at 6 and 12 months after controlling for baseline caregivers’ depression and baseline patients’ SI.

Lastly, the researchers found that higher patient depression scores at all follow-up points were associated with higher caregiver depression scores after controlling for confounding factors.

Writing in the journal Bipolar Disorders, the team concludes: “Improving caregivers’ health may depend in some cases on fully stabilizing patients.”

They add: “Future research may be able to clarify why some caregivers are resilient even in the face of patients’ depression and SI.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

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The Stanford University School of Medicine will host its fifth annual Bipolar Education Day on July 25. Individuals with bipolar disorder, their families, caregivers, friends and interested community members are invited to attend.

The free event will be held at the William R. Hewlett Teaching Center at 370 Serra St., located on the main campus.

More than 5.7 million Americans have bipolar disorder, a psychiatric illness that causes unusually intense shifts in mood, energy and behavior. Bipolar Education Day gives scientists and clinicians an opportunity to discuss the previous year’s research findings with individuals and families affected by the disorder.

This year’s speakers include Terence Ketter, MD, professor of psychiatry and behavioral sciences and chief of Stanford’s Bipolar Disorders Clinic; Po Wang, MD, and Jenifer Culver, PhD, from the Stanford Bipolar Disorders Clinic; Manpreet Singh, MD, from the Stanford Pediatric Bipolar Disorders Program; and representatives from the National Alliance on Mental Illness and the Depression and Bipolar Support Alliance. Speakers will discuss treatment options that can help patients manage their symptoms. An afternoon question-and-answer session will follow the talks.

“I’m looking forward to a chance to share some of the latest advances in research at this year’s Education Day,” said Ketter.

The program runs from 8:30 a.m. to 2:30 p.m. and includes complimentary morning beverages and an afternoon snack. Pre-registration is required. For more information or to register, please visit http://www.bipolar.org or contact Meredith Childers at mchilder@stanford.edu.

Source
The Stanford University School of Medicine

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