Gender differences in age at onset of Schizophrenia

Abstract

We present the results of a review of the literature concerning gender differences in age at the onset of schizophrenia. In view of the very consistent finding that the first admission to hospital for schizophrenia occurs on average earlier in men than in women we examined the question whether this is due to the fact that the psychosis manifests itself earlier in men or that the period between first manifestation and admission to hospital is shorter than in women. By means of a metaanalytic approach we then looked for evidence for the existence of local or temporal variations in the degree of gender difference. Lastly, we dealt with the question whether gender differences in age of onset can be observed in other functional psychoses.

Dopa decarboxylase genotypes may influence age at onset of schizophrenia

“…9 A similar, yet statistically insignificant, tendency was observed in the present patient sample. We therefore investigated the influence of DDC on age at onset in each sex separately.…”

“…8 There is also evidence pointing at a possible specific involvement of dopaminergic neurotransmission in determining the age at onset of schizophrenia. Numerous studies have found that the onset of schizophrenia for females is later than that for males, 9 and this has been suggested to be due to the influence of estrogen on dopaminergic neurotransmission. 10 Given the evidence outlined above, DDC is an interesting candidate gene for susceptibility to schizophrenia and for influencing age at disease onset.…”

An Update on the Epidemiology of Schizophrenia*

“…Before age 30, incidence rates tend to be higher for males than females; after age 30, incidence rates are either equal for the two sexes, or higher among females (52,59). On average, when male schizophrenics first come into contact with the treatment system, they are four to five years younger than corresponding females (52,54,57,59,60) .…”

Contrasting Effects of Increased and Decreased Dopamine Transmission on Latent Inhibition in Ovariectomized Rats and Their Modulation by 17β-Estradiol: An Animal Model of Menopausal Psychosis?

“…Women have a more favorable illness course during the reproductive years, characterized by later onset of symptoms, lower symptom severity, and better response to antipsychotic drug (APD) treatment (Agius et al, 2009;Angermeyer and Kuhn, 1988;Hafner, 2003;Hafner et al, 1989;Iacono and Beiser, 1992;Lindamer et al, 1997;Mortimer, 2007;Pregelj, 2009;Riecher-Rossler and Hafner, 2000;Salem and Kring, 1998;Seeman, 1982Seeman, , 1986Szymanski et al, 1995;Tamminga, 1997). In contrast, menopause is associated with increased vulnerability to illness, elevated symptom severity, and reduced response to treatment (Horacek et al, 2006;Kulkarni et al, 1996Kulkarni et al, , 2008bLane et al, 1999;Salokangas, 1995;Saugstad, 1989;Seeman and Lang, 1990).…”