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Sex differences in schizophrenia.

Abstract

Evidence suggests sex differences in schizophrenia reflect differences in both neurodevelopmental processes and social effects on disease risk and course. Male:female incidence approximates 1.4:1 but at older onset women predominate. Prevalence differences appear smaller. Men have poorer premorbid adjustment and present with worse negative and less depressive symptoms than women, which may explain their worse medium term outcome according to a range of measures. Substance abuse is a predominantly male activity in this group, as elsewhere. Findings of sex differences in brain morphology are inconsistent but occur in areas that normally show sexual dimorphism, implying that the same factors are important drivers of sex differences in both normal neurodevelopmental processes and those associated with schizophrenia. There are sex differences in antipsychotic responses but sex-specific endocrine effects on illness and response to antipsychotics are potentially complex. Oestrogen's role as an adjunctive medication is not yet clear due to methodological differences between the few randomized controlled trials. Services that are sensitive to differences in gender can better meet their patients' specific needs and potentially improve outcome.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Centre for Women's Mental Health, School of Community Based Medicine, University of Manchester, Oxford Road, Manchester, UK. Kathryn.M.Abel@manchester.ac.uk

    ,

    Source

    MeSH

    Age Factors
    Antipsychotic Agents
    Brain
    Depression
    Female
    Humans
    Incidence
    Male
    Men
    Prevalence
    Risk Factors
    Schizophrenia
    Schizophrenic Psychology
    Sex Factors
    Social Adjustment
    Substance-Related Disorders
    Treatment Outcome
    Women

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    21047156

    Citation

    Abel, Kathryn M., et al. "Sex Differences in Schizophrenia." International Review of Psychiatry (Abingdon, England), vol. 22, no. 5, 2010, pp. 417-28.
    Abel KM, Drake R, Goldstein JM. Sex differences in schizophrenia. Int Rev Psychiatry. 2010;22(5):417-28.
    Abel, K. M., Drake, R., & Goldstein, J. M. (2010). Sex differences in schizophrenia. International Review of Psychiatry (Abingdon, England), 22(5), pp. 417-28. doi:10.3109/09540261.2010.515205.
    Abel KM, Drake R, Goldstein JM. Sex Differences in Schizophrenia. Int Rev Psychiatry. 2010;22(5):417-28. PubMed PMID: 21047156.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Sex differences in schizophrenia. AU - Abel,Kathryn M, AU - Drake,Richard, AU - Goldstein,Jill M, PY - 2010/11/5/entrez PY - 2010/11/5/pubmed PY - 2011/3/2/medline SP - 417 EP - 28 JF - International review of psychiatry (Abingdon, England) JO - Int Rev Psychiatry VL - 22 IS - 5 N2 - Evidence suggests sex differences in schizophrenia reflect differences in both neurodevelopmental processes and social effects on disease risk and course. Male:female incidence approximates 1.4:1 but at older onset women predominate. Prevalence differences appear smaller. Men have poorer premorbid adjustment and present with worse negative and less depressive symptoms than women, which may explain their worse medium term outcome according to a range of measures. Substance abuse is a predominantly male activity in this group, as elsewhere. Findings of sex differences in brain morphology are inconsistent but occur in areas that normally show sexual dimorphism, implying that the same factors are important drivers of sex differences in both normal neurodevelopmental processes and those associated with schizophrenia. There are sex differences in antipsychotic responses but sex-specific endocrine effects on illness and response to antipsychotics are potentially complex. Oestrogen's role as an adjunctive medication is not yet clear due to methodological differences between the few randomized controlled trials. Services that are sensitive to differences in gender can better meet their patients' specific needs and potentially improve outcome. SN - 1369-1627 UR - https://www.unboundmedicine.com/medline/citation/21047156/full_citation L2 - http://www.tandfonline.com/doi/full/10.3109/09540261.2010.515205 DB - PRIME DP - Unbound Medicine ER -