Gender Differences in Poor Outcome Patients With Lifelong Schizophrenia

Abstract

Gender effects have been reported quite consistently in schizophrenia, with male patients having an earlier age of onset, poorer functional outcome, greater negative symptoms and cognitive impairment, and less severe positive symptoms. Because age of onset, cognitive impairments, and negative symptoms are all correlated with poorer functional status, it is not clear if previously reported gender differences in symptoms are just recapturing gender differences in functional outcome. In this study, 205 geriatric patients with lifelong poor-outcome schizophrenia (43% male) were examined for the severity of schizophrenic symptoms, cognitive impairments, and specific deficits in adaptive skills, as well as for demographic differences such as age at first psychiatric admission, premorbid education, and current treatment status. Previously reported gender differences were replicated in these patients with a uniformly poor functional outcome, with male patients having more severe negative symptoms and an earlier age of first psychiatric admission. No differences in cognitive functioning or specific functional deficits were found, however. These findings suggest that negative symptom severity is greater in male patients regardless of functional outcome and that the association of cognitive deficits with gender may be found only in patients with better functional outcome. The study of gender-related differences in brain structure or function and their interaction with overall course of illness might help understand these differences in symptom presentation.

Gender differences in cognitive deficits in schizophrenia with and without diabetes

“…However, both the current and other previous studies have found that males have worse negative symptoms, response to antipsychotics, and cognitive deficits than females with schizophrenia [6][7][8][9][11][12][13]. This may affect more daily life and self-medical protection awareness for male individuals and lead to their poorer glycemic control.…”

“…Male individuals have an early age of onset, worse negative symptoms, and a worse response to antipsychotics than female individuals with schizophrenia [6][7][8][9]. A recent study found a lower prevalence of diabetes in male than female individuals with schizophrenia [10].…”

Qualidade de vida e dimensão ocupacional na esquizofrenia: uma comparação por sexo

“…Na regressão logística, o procedimento consistiu em selecionar inicialmente as variáveis que na análise univariada apresentaram valor p ≤ 0, 25, exceção feita para idade e duração da doença, que entraram no modelo independentemente do valor-p apresentado devido à sua relevância clínica 1,11,20,21,22 . A premissa de chances proporcionais foi testada para todas as variá-veis individualmente e para o modelo final 19,23 .…”

“…Diferenças foram detectadas quanto à sua distribuição, características, evolução 10 e, mais recentemente, na qualidade de vida 4,6,7,8,9,11,12 . A maioria desses estudos indica que homens e mulheres possuem diferentes experiências com a esquizofrenia, mas pouco se conhece sobre o reflexo dessas diferenças na percepção do paciente sobre sua qualidade de vida e, principalmente, sobre as suas implicações para a prática clínica e para o planejamento dos serviços de saúde mental 10 .…”

As bases biológicas da Esquizofrenia

“…A doença surge geralmente em adultos jovens, com maior prevalência (Saha, Welham, Chant, & McGrath, 2006) e início mais precoce (Moriarty et al, 2001), no sexo masculino. Os doentes apresentam uma baixa taxa de matrimónio e altas taxas de divórcio e desemprego de longa duração, o que frequentemente leva à pobreza e à situação de sem-abrigo (Thornicroft et al, 2004); os que têm perturbações psicóticas graves apresentam, mais frequentemente, comportamento agressivo (Hodgins & Muller-Isberner, 2004).…”