Characterization of Psychiatric Inpatients: The Role of Gender Differences in Clinical and Pharmacological Patterns

Background: Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients. Methods: We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge. Results: Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43 +/- 10.73 d vs. 10.52 +/- 10.37 d, t=-2.099, gl = 2356, P = 0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, chi(2) = 9.616, gl = 1, P = 0.002), more use of illicit substances (34.1% vs. 20.9%, chi(2) = 51.084, gl = 1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, chi(2) = 17.182, gl = 1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients. Conclusions: Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.