Women with bipolar disorder: Findings from the NIMH genetics initiative sample

Bipolar l (BPl) mood disorder is a severe recurrent mental illness with a p opulation prevalence of 1 percent. Evidence is strong for genetic risk fact ors in onset. However, unlike unipolar mood disorders, in which women outnu mber men by 2 to 1, for BPl disorder, the male:female ratio is equal. Perha ps for this reason, relatively little research has examined gender-related risks in BPl course, This article presents data from 186 BPl women and 141 BPl men ascertained as part of the NIMH Genetics initiative, a multisite co llaborative molecular genetic study. Subjects were interviewed using the Diagnostic Interview for Genetic Studie s (DIGS), DIGS items included a medical history, and for women, questions c oncerning psychiatric disorders in relation to childbearing, the menstrual cycle, and menopause. Almost half of BPl women who had been pregnant report ed having experienced severe emotional disturbances in relation to childbea ring, with close to one third reporting episode onset during pregnancy. Two -thirds of BPl women reported frequent premenstrual mood disturbances and a lmost 20 percent of postmenopausal BPl women reported severe emotional dist urbances during the menopausal transition. More BPl women than men reported thyroid disorder and migraine headaches. Findings are discussed in relation to gender differences in population and other clinical samples, and in terms of their implications for the developm ent of new treatments and preventive Interventions.