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. 2013 Jul;149(1-3):269-76.
doi: 10.1016/j.jad.2013.01.040. Epub 2013 Feb 26.

Does sex moderate the clinical correlates of pediatric bipolar-I disorder? Results from a large controlled family-genetic study

Janet Wozniak  1 , Joseph Biederman, Mary Kate Martelon, Mariely Hernandez, K Yvonne Woodworth, Stephen V Faraone
Affiliations

Does sex moderate the clinical correlates of pediatric bipolar-I disorder? Results from a large controlled family-genetic study

Janet Wozniak et al. J Affect Disord. 2013 Jul.

Abstract

Background: Since little is known as to whether sex differences affect the clinical presentation of pediatric BP-I disorder, it is an area of high clinical, scientific and public health relevance.

Methods: Subjects are 239 BP-I probands (65 female probands, 174 male probands) and their 726 first-degree relatives, and 136 non-bipolar, non-ADHD control probands (37 female probands, 99 male probands) and their 411 first-degree relatives matched for age and sex. We modeled the psychiatric and cognitive outcomes as a function of BP-I status, sex, and the BP-I status-gender interaction.

Results: BP-I disorder was equally familial in both sexes. With the exception of duration of mania (shorter in females) and number of depressive episodes (more in females), there were no other meaningful differences between the sexes in clinical correlates of BP-I disorder. With the exception of a significant sex effect for panic disorder and a trend for substance use disorders (p=0.05) with female probands being at a higher risk than male probands, patterns of comorbidity were similar between the sexes. Despite the similarities, boys with BP-I disorder received more intensive and costly academic services than girls with the same disorder.

Limitations: Since we studied children referred to a family study of bipolar disorder, our findings may not generalize to clinic settings.

Conclusions: We found more similarities than differences between the sexes in the personal and familial correlates of BP-I disorder. Clinicians should consider bipolar disorder in the differential diagnosis of both boys and girls afflicted with symptoms suggestive of this disorder.

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Conflict of interest statement

CONFLICT OF INTEREST

Janet Wozniak MD is a speaker for Primedia/MGH Psychiatry Academy, and receives research support from McNeil, Shire, Janssen, and Johnson & Johnson. Her spouse, John Winkelman MD, PhD, is a consultant/advisory board for Impax Laboratories, Pfizer, UCB, Zeo Inc., Sunovion, and receives research support from GlaxoSmithKline.

Dr. Joseph Biederman is currently receiving research support from the following sources: Elminda, Janssen, McNeil, and Shire. In 2012, Dr. Joseph Biederman received an honorarium from the MGH Psychiatry Academy and The Children’s Hospital of Southwest Florida/Lee Memorial Health System for tuition-funded CME courses. In 2011, Dr. Joseph Biederman gave a single unpaid talk for Juste Pharmaceutical Spain, received honoraria from the MGH Psychiatry Academy for a tuition-funded CME course, and received an honorarium for presenting at an international scientific conference on ADHD. He also received an honorarium from Cambridge University Press for a chapter publication. Dr. Biederman received departmental royalties from a copyrighted rating scale used for ADHD diagnoses, paid by Eli Lilly, Shire and AstraZeneca; these royalties are paid to the Department of Psychiatry at MGH. In 2010, Dr. Joseph Biederman received a speaker’s fee from a single talk given at Fundación Dr. Manuel Camelo A.C. in Monterrey Mexico. Dr. Biederman provided single consultations for Shionogi Pharma Inc. and Cipher Pharmaceuticals Inc.; the honoraria for these consultations were paid to the Department of Psychiatry at the MGH. Dr. Biederman received honoraria from the MGH Psychiatry Academy for a tuition-funded CME course. In previous years, Dr. Joseph Biederman received research support, consultation fees, or speaker’s fees for/from the following additional sources: Abbott, Alza, AstraZeneca, Boston University, Bristol Myers Squibb, Celltech, Cephalon, Eli Lilly and Co., Esai, Fundacion Areces (Spain), Forest, Glaxo, Gliatech, Hastings Center, Janssen, McNeil, Medice Pharmaceuticals (Germany), Merck, MMC Pediatric, NARSAD, NIDA, New River, NICHD, NIMH, Novartis, Noven, Neurosearch, Organon, Otsuka, Pfizer, Pharmacia, Phase V Communications, Physicians Academy, The Prechter Foundation, Quantia Communications, Reed Exhibitions, Shire, the Spanish Child Psychiatry Association, The Stanley Foundation, UCB Pharma Inc., Veritas, and Wyeth.

In the past year, Dr. Faraone received consulting income and/or research support from Shire, Otsuka and Alcobra and research support from the National Institutes of Health (NIH). He is also on the Clinical Advisory Board for Akili Interactive Labs. In previous years, he received consulting fees or was on Advisory Boards or participated in continuing medical education programs sponsored by: Shire, McNeil, Janssen, Novartis, Pfizer and Eli Lilly. Dr. Faraone receives royalties from books published by Guilford Press: Straight Talk about Your Child’s Mental Health and Oxford University Press: Schizophrenia: The Facts.

MaryKate Martelon, Mariely Hernandez, and K. Yvonne Woodworth report no conflicts of interest.

Figures

Figure 1
Figure 1
Mania Symptoms in Male and Female Probands (N=199)
Figure 2
Figure 2
Social Environment and Behavior - Social Adjustment Inventory for Children (SAICA) (N=251)
Figure 3
Figure 3
Figure 4
Figure 4
Familial risk of Bipolar-I (BP-I) Disorder in First-Degree Relatives Stratified by Proband Sex
See this image and copyright information in PMC

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