Young men and boys with bipolar disorder – The missing (and unaware) middle in early intervention!

Although debate remains about gender differences in the experience of bipolar disorder, current evidence indicates that women more often present with depressive burden, bipolar disorder-II, psychotic depression, depressive polarity and greater comorbidity. They experience greater functional and multimorbidity burden, although there is evidence men present with greater functional impairment with first-episode mania. Men more often present with earlier onset, first episode mania, substance use and forensic involvement. In this viewpoint, we describe insights from establishing an early intervention service for youth with bipolar disorder, emphasise evident gender disparities and highlight recommendations for clinicians and health-system managers to improve early recognition, access to care and reduce risks, for boys and young men with bipolar disorder.