Gender differences in outcomes of acute mania: a 12-month follow-up study

This study aimed to assess short-term (12 weeks) and long-term (12 months) gender differences in the outcomes of patients
experiencing an episode of mania in the course of bipolar disorder. European Mania in Bipolar Longitudinal Evaluation of Medication
was a 2-year, prospective, observational study of the outcomes of patients with a manic or mixed episode conducted in 14 European
countries. Data were collected during the acute phase (12 weeks) and during a follow-up period (up to 12 months). Analyses
were carried out in the subgroup of patients identified with a pure manic episode at baseline. Kaplan–Meier survival analysis
estimated time to first occurrence of mania improvement, worsening, recovery and depressive episode, and Cox’s proportional
hazards models were used to analyse factors associated with these outcomes. Overall, 2,485 patients (46.6% men, 53.4% women)
were included in the analysis. Frequency of substance abuse was higher in men than women. No significant gender differences
were found in the severity of manic symptoms at baseline. There were no gender differences in assessment of mania improvement,
worsening or recovery over 12 weeks, but more women than men showed mania improvement over 12 months (95.4% vs. 89.2%; p < 0.01). Significantly more women developed a depressive episode over 12 weeks (14.9% vs. 9.7%; p < 0.01) and over 12 months (27.7% vs. 21.5%; p < 0.001). In conclusion, the results show that there are small gender differences in the course of patients experiencing
a pure manic episode. Women had a faster time to mania improvement and a higher risk of developing a depressive episode during
the 12-month follow-up period.