Increased depressive symptoms in menopausal age women with bipolar disorder: Age and gender comparison
ABSTRACT Emerging data suggest the menopausal transition may be a time of increased risk for depression. This study examines the course of bipolar disorder focusing on depressive symptoms in menopausal transition age women, compared to similar-aged men as well as younger adult women and men.
Outpatients with bipolar disorder were assessed with the systematic treatment enhancement program for bipolar disorder (STEP-BD) affective disorders evaluation and longitudinally monitored during naturalistic treatment with the STEP-BD clinical monitoring form. Clinical status (syndromal/subsyndromal depressive symptoms, syndromal/subsyndromal elevation or mixed symptoms, and euthymia) was compared between menopausal transition age women (n=47) and pooled similar-aged men (n=30) 45-55 years old, younger women (n=48) and men (n=39) 30-40 years old.
Subjects included 164 bipolar disorder patients (67 type I, 82 type II, and 15 not otherwise specified), 34% were rapid cycling and 58% women. Bipolar II disorder/bipolar NOS was more common in women. Monitoring averaged 30+/-22 months, with an average of 0.9+/-0.5 clinic visits/month. Menopausal age women had a significantly greater proportion of visits with depressive symptoms (p<0.05), significantly fewer euthymic visits (p<0.05) and no difference in proportion of visits with elevated/mixed symptoms compared to pooled comparison group.
Menopausal transition age women with bipolar disorder experience a greater proportion of clinic visits with depressive symptoms compared to similarly aged men, and younger women and men with bipolar disorder. Further systematic assessment on the influence of the menopausal transition and reproductive hormones upon mood is needed to better inform clinical practice in treating women with bipolar disorder.
- SourceAvailable from: Carlos A. Grattoni[Show abstract] [Hide abstract]
ABSTRACT: Wettability has a strong impact on many oil recovery processes. However, the determination and restoration of reservoir wettability in the laboratory is still problematic, due to the difficulty in reproducing reservoir conditions. Wettability changes are usually achieved in the laboratory by aging the rock samples with selected crude oils, or by chemical treatment of the solid surfaces. The objective of this work is to study the effects of wettability alteration, by aging silica gels, placed within a porous medium, on the ability of oil and water to flow through that medium.A series of experiments was performed to visualise oil and water flow through a porous medium containing silica gel. The experiments were conducted in transparent glass models in which the flow events and the fluid distribution were clearly visible and could be recorded. To form the gel in situ, an alkyl silicate gelant was used, which is soluble in an organic phase, and which, when in contact with water, reacts to convert the water phase into a gel. The newly formed silica gel is water-wet, but when aged in paraffin, interesting changes are observed over time: the surface wettability changes to finally become oil-wet, while small cracks develop within the gel structure.The gel was placed in both strongly water-wet and oil-wet models, which, combined with the gel behaviour, generated a wide range of flow and wettability conditions, i.e., water-wet, intermediate-wet, mixed-wet and oil-wet. The visual observations are complemented by measurements of end-point relative permeabilities, allowing the demonstration of the effects of wettability upon relative permeability. The fluid distribution at pore level and the hierarchy of wetting determine the flow characteristics. The high values of both oil and water relative permeabilities correspond to the strongly wetting conditions, which agrees with the traditional description of oil–water distribution within porous media. On the other hand, the intermediate-wet case has the lower oil and water relative permeability, with the oil permeability proportional to the fraction of the surface that is oil-wet. The mixed-wet cases have intermediate oil and water permeability, but show an increase in water relative permeability as the amount of water-wet surface decreases. These results have important implications in the design and performance of wellbore gel treatments, which are used to modify water and oil flow behaviour.Journal of Petroleum Science and Engineering 04/2002; DOI:10.1016/S0920-4105(01)00181-4 · 1.10 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Significant sex differences have been described for mental disorders in terms of prevalence, symptom presentation and prescription of psychotropic medication. Most of the published studies and reviews emphasize the impact of female-specific reproductive events on the course of the mental illness or sex difference of the adverse effects of psychotropic medication or the concerns about treatment of female patients during the perinatal period. Different from other reviews, we will summarize the effects of current mental disorder/psychotropic medication on the female-specific reproduction-related events (such as menstrual regularity, pregnancy, postpartum period and menopause). A number of recent studies have highlighted the adverse effects of psychotropic agents on the female reproductive system, especially on the regularity of the menstrual cycle or on the female gonadal hormones. Without any medication, disturbances of the female gonadal system are observed especially among severely mentally ill female patients. In the studies, the prevalence of female-specific gonadal abnormalities and their mechanism of action, prevention and recommendations are given in detail. The field of reproductive psychiatry is rapidly evolving. There is increasing evidence that clinicians should be aware of female medical health while treating severely mentally ill female patients. Analyzing the present data will further advance our understanding of treatment safety and impact of untreated mental illness in women.Current opinion in psychiatry 07/2010; 23(4):378-82. DOI:10.1097/YCO.0b013e32833ae437 · 3.55 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Sex is clearly important in unipolar mood disorder with compelling evidence that depression is approximately twice as common in women than in men. In the case of bipolar disorder, however, it is widely perceived that the reported equal rate of illness in men and women reflects no important gender distinctions. In this paper we review the literature on gender differences in bipolar illness and attempt to summarize what is known and what requires further study. Despite the uncertainties that remain some conclusions can be drawn. Most studies, but not all, report an almost equal gender ratio in the prevalence of bipolar disorder but the majority of studies do report an increased risk in women of bipolar II/hypomania, rapid cycling and mixed episodes. Important gender distinctions are also found in patterns of co-morbidity. No consistent gender differences have been found in a number of variables including rates of depressive episodes, age and polarity of onset, symptoms, severity of the illness, response to treatment and suicidal behaviour. Unsurprisingly, however, perhaps the major distinction between men and women with bipolar disorder is the impact that reproductive life events, particularly childbirth, have on women with this diagnosis.International Review of Psychiatry 10/2010; 22(5):437-52. DOI:10.3109/09540261.2010.514601 · 1.80 Impact Factor