Grant: Travel Awards - Institute Community Support

Background: Women are twice as likely as men to experience Unipolar Depression (UD) and women with Bipolar Disorder (BD) often have more frequent depressive and hypo/manic episodes in a year (rapid cycling) than men. Social determinants of health (SDoH), such as economic instability and low social support, are more common in women with BD and linked to greater UD severity in women. Psychosocial functioning, the ability to manage daily tasks and relationships, is often worse in those with more severe symptoms, increasing the risk of long-term disability. It is unclear how SDoH affect functioning differently by sex and gender. To address this, we will examine how gender-related SDoH (household income, education, relationship status) interact with sex (male[M]/female[F]) or gender identity (man/woman) in BD and UD across 2 cohorts. Methods: Treatment seeking individuals (N=912) at St. Joseph's Healthcare Hamilton (SJHH) were screened for BD and UD using intake questionnaires. A community sample (ENABLE, N=499) used structured clinical interviews to confirm diagnoses. The Functioning Assessment Short Test (FAST) measured psychosocial functioning (e.g., work, autonomy). We will test if SDoH interact with gender identity to predict FAST scores in BD and UD screen groups, and with sex in BD and UD diagnoses in ENABLE. A separate descriptive analysis will examine intersex and transgender/gender-diverse (TGD) participants. Results: The SJHH sample includes 273 positive BD screens (67.8% women, 28.9% men, 3.3% TGD) and 560 positive UD screens (68.6% women, 30.2% men, 1.2% TGD). ENABLE includes 114 confirmed BD (61.4% F, 37.7% M, 0.9% intersex) and 385 confirmed UD (68% F, 31.7% M, 0.3% intersex) diagnoses, and a subset with gender identity: 33 BD (54.5% Women, 30.3% Men, 15.2% TGD) and 101 UD (56.4% Women, 35.6% Men, 8% TGD). Full results will be presented in September 2026. Impact: SDoH may affect functioning differently by sex/gender, highlighting new targets in BD/UD.