Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis
Abstract Introduction Impairment in both psychosocial functioning and neurocognition (NC) performance is present in bipolar disorder (BD) yet the role of sex differences in these deficits remains unclear. The present systematic review and meta-analysis examined whether males and females with BD de...
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Cambridge University Press
2025-01-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933825000276/type/journal_article |
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| author | Maria Serra-Navarro Derek Clougher Vincenzo Oliva Clàudia Valenzuela-Pascual Michele De Prisco María Florencia Forte Marina Garriga Brisa Solé Jose Sánchez-Moreno Norma Verdolini Giulia Menculini Alfonso Tortorella Miquel Bernardo J. Antoni Ramos-Quiroga Anabel Martinez-Aran Eduard Vieta Silvia Amoretti Carla Torrent |
| author_facet | Maria Serra-Navarro Derek Clougher Vincenzo Oliva Clàudia Valenzuela-Pascual Michele De Prisco María Florencia Forte Marina Garriga Brisa Solé Jose Sánchez-Moreno Norma Verdolini Giulia Menculini Alfonso Tortorella Miquel Bernardo J. Antoni Ramos-Quiroga Anabel Martinez-Aran Eduard Vieta Silvia Amoretti Carla Torrent |
| author_sort | Maria Serra-Navarro |
| collection | DOAJ |
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Abstract
Introduction
Impairment in both psychosocial functioning and neurocognition (NC) performance is present in bipolar disorder (BD) yet the role of sex differences in these deficits remains unclear. The present systematic review and meta-analysis examined whether males and females with BD demonstrate differences in psychosocial functioning and NC performance.
Methods
The Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases were systematically searched from inception until November 20, 2023.
Results
Twenty studies published between 2005 and 2023 with a total sample size of 2286 patients with BD were included. A random effects meta-analysis revealed a statistically significant result with a small effect (SMD = 0.313) for sex differences in verbal learning and memory as well as visual learning and memory (SMD = 0.263). Females outperformed males in both domains. No significant sex differences were observed for any other NC outcome or psychosocial functioning. High heterogeneity and differences in assessment scales used should be considered when interpreting these findings, given their potential impact on results.
Conclusions
Future research should adopt a more homogenous, standardized approach using longitudinal designs to gain a clearer insight into sex differences in this population. This approach so may increase the use of preventative therapeutic options to address the difficult clinical challenge of reaching cognitive and functional recovery.
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| format | Article |
| id | doaj-art-b69f2c03c6334b4e92cf66a4095d67bc |
| institution | DOAJ |
| issn | 0924-9338 1778-3585 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj-art-b69f2c03c6334b4e92cf66a4095d67bc2025-08-20T03:02:47ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.27Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysisMaria Serra-Navarro0https://orcid.org/0000-0002-9736-4630Derek Clougher1https://orcid.org/0000-0001-7631-3845Vincenzo Oliva2https://orcid.org/0000-0002-5961-6032Clàudia Valenzuela-Pascual3https://orcid.org/0009-0002-0495-7793Michele De Prisco4https://orcid.org/0000-0002-2032-1181María Florencia Forte5Marina Garriga6Brisa Solé7https://orcid.org/0000-0003-1673-8248Jose Sánchez-Moreno8https://orcid.org/0000-0003-1520-093XNorma Verdolini9https://orcid.org/0000-0001-9488-2881Giulia Menculini10Alfonso Tortorella11https://orcid.org/0000-0002-8095-2305Miquel Bernardo12https://orcid.org/0000-0001-8748-6717J. Antoni Ramos-Quiroga13https://orcid.org/0000-0003-1622-0350Anabel Martinez-Aran14https://orcid.org/0000-0002-0623-6263Eduard Vieta15https://orcid.org/0000-0002-0548-0053Silvia Amoretti16https://orcid.org/0000-0001-6017-2734Carla Torrent17https://orcid.org/0000-0003-0335-582XBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, Spain BIOARABA, Department Psychiatry. Hospital Universitario de Alava. CIBERSAM. University of the Basque Country, Vitoria, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, Spain BIOARABA, Department Psychiatry. Hospital Universitario de Alava. CIBERSAM. University of the Basque Country, Vitoria, SpainLocal Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, ItalyDepartment of Psychiatry, University of Perugia, Perugia, ItalyDepartment of Psychiatry, University of Perugia, Perugia, ItalyBarcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, SpainDepartment of Mental Health, Hospital Universitari Vall d’Hebron, Barcelona, Catalonia, Spain Group of Psychiatry, Mental Health and Addictions, Valld’Hebron Research Institute [VHIR], Vall d’Hebron Research Institute [VHIR], Barcelona, CIBERSAM Catalonia, Spain Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, SpainDepartment of Mental Health, Hospital Universitari Vall d’Hebron, Barcelona, Catalonia, Spain Group of Psychiatry, Mental Health and Addictions, Valld’Hebron Research Institute [VHIR], Vall d’Hebron Research Institute [VHIR], Barcelona, CIBERSAM Catalonia, SpainBipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Fundació Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer [IDIBAPS], CIBERSAM, ISCIII, Barcelona, Spain Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències [UBNeuro], Universitat de Barcelona [UB], Barcelona, Spain Abstract Introduction Impairment in both psychosocial functioning and neurocognition (NC) performance is present in bipolar disorder (BD) yet the role of sex differences in these deficits remains unclear. The present systematic review and meta-analysis examined whether males and females with BD demonstrate differences in psychosocial functioning and NC performance. Methods The Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases were systematically searched from inception until November 20, 2023. Results Twenty studies published between 2005 and 2023 with a total sample size of 2286 patients with BD were included. A random effects meta-analysis revealed a statistically significant result with a small effect (SMD = 0.313) for sex differences in verbal learning and memory as well as visual learning and memory (SMD = 0.263). Females outperformed males in both domains. No significant sex differences were observed for any other NC outcome or psychosocial functioning. High heterogeneity and differences in assessment scales used should be considered when interpreting these findings, given their potential impact on results. Conclusions Future research should adopt a more homogenous, standardized approach using longitudinal designs to gain a clearer insight into sex differences in this population. This approach so may increase the use of preventative therapeutic options to address the difficult clinical challenge of reaching cognitive and functional recovery. https://www.cambridge.org/core/product/identifier/S0924933825000276/type/journal_articlebipolar disordermeta-analysisneurocognitionpsychosocial functioningsex |
| spellingShingle | Maria Serra-Navarro Derek Clougher Vincenzo Oliva Clàudia Valenzuela-Pascual Michele De Prisco María Florencia Forte Marina Garriga Brisa Solé Jose Sánchez-Moreno Norma Verdolini Giulia Menculini Alfonso Tortorella Miquel Bernardo J. Antoni Ramos-Quiroga Anabel Martinez-Aran Eduard Vieta Silvia Amoretti Carla Torrent Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis European Psychiatry bipolar disorder meta-analysis neurocognition psychosocial functioning sex |
| title | Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis |
| title_full | Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis |
| title_fullStr | Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis |
| title_full_unstemmed | Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis |
| title_short | Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis |
| title_sort | sex differences in psychosocial functioning and neurocognition in bipolar disorder a systematic review and meta analysis |
| topic | bipolar disorder meta-analysis neurocognition psychosocial functioning sex |
| url | https://www.cambridge.org/core/product/identifier/S0924933825000276/type/journal_article |
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