Sociodemographic and clinical characteristics among individuals with bipolar disorder in Pakistan - a gender-focused...

Bipolar disorder (BD) is a relapsing and remitting mental disorder affecting over 40 million people worldwide, with a substantial burden in low- and middle-income countries (LMICs). There is limited knowledge on BD in Pakistan. Understanding sociodemographic and clinical characteristics of BD is needed for developing culturally and contextually relevant interventions.

This secondary analysis includes 2553 participants with BD from eight major cities in Pakistan who completed the baseline screening for two randomized controlled trials (RCTs) on pharmacological and psychosocial interventions for BD. Chi-squared tests were used to examine gender differences in the clinical symptoms. Logistic regression models adjusted for age, gender, marital status, education, socioeconomic status, and substance use were used to identify variables associated with clinically meaningful symptoms in BD.

The majority of participants of both genders reported low educational attainment, underemployment, and low socioeconomic status. Women were more likely than men to experience negative clinical outcomes, including depression, anxiety, insomnia, and suicidality, and yet were less likely to be eligible to enroll in RCTs. Logistic regression models further identified the women gender to be significantly associated with various clinically meaningful symptoms in BD.

To our knowledge, this analysis is the largest investigation of sociodemographic and clinical characteristics of patients with BD in Pakistan. Our findings of gender differences in BD symptoms emphasize the need for equitable, gender-sensitive mental health care, which is essential to improving outcomes and promoting inclusive mental health service and research in LMICs.