Gender differences in bipolar disorder: age of onset, course, comorbidity, and symptom presentation


  • The authors of this paper do not have any commercial associations that might pose a conflict of interest in connection with this manuscript.

Dr Janet Carter, Department of Psychological Medicine, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand.
Fax: +64 3 372 0407;


Objective:  To determine whether men and women with bipolar disorder differ in age of onset, course of illness, number of suicide attempts, comorbidity rates and symptom presentation.

Method:  Data were collected from 211 (121 women; 90 men) adults using the Diagnostic Interview for Genetic Studies, medical records, and additional information gathered from relatives.

Results:  Most gender comparisons showed no evidence of differences. Nonetheless, more men than women reported mania at the onset of bipolar I disorder. Men also had higher rates of comorbid alcohol abuse/dependence, cannabis abuse/dependence, pathological gambling and conduct disorder. Men were more likely to report ‘behavioural problems’ and ‘being unable to hold a conversation’ during mania. Women reported higher rates of comorbid eating disorders, and weight change, appetite change and middle insomnia during depression.

Conclusions:  Men and women were generally similar in their symptom presentation, age of onset of bipolar disorder, and in the total number of mood episodes. However, they differed in the type of episode at onset and comorbidity patterns.