Gender differences in quality of life and the course of schizophrenia: national study

Abstract

Background Evidence from various sources suggests that females with schizophrenia tend to report lower quality of life than males with schizophrenia despite having a less severe course of the disorder. However, studies have not examined this directly. Aims To examine gender differences in the association between quality of life and the risk of subsequent psychiatric hospital admissions in a national sample with schizophrenia. Method The sample consisted of 989 (60.90%) males and 635 (39.10%) females with an ICD-10 diagnosis of schizophrenia. Quality of life was assessed and scored using the Manchester Short Assessment of Quality of Life. The course of schizophrenia was assessed from the number of psychiatric hospital admissions. Participants completed the quality of life assessment and were then followed up for 18-months for subsequent psychiatric admissions. Hazard ratios (HR) from Cox proportional hazards regression models were estimated unadjusted and adjusted for covariates (age at schizophrenia onset and birth year). Analyses were computed for males and females separately, as well as for the entire cohort. Results A subsample of 93 males and 55 females was admitted to a psychiatric hospital during follow-up. Higher quality of life scores were significantly (P < 0.05) associated with a reduced risk of subsequent admissions among males (unadjusted: HR = 0.96, 95% CI 0.93–0.99; adjusted HR = 0.96, 95% CI 0.93–0.99) but not among females (unadjusted: HR = 0.97, 95% CI 0.93–1.02; adjusted HR = 0.97, 95% CI 0.93–1.02). Conclusions Quality of life in schizophrenia is a gender-specific construct and should be considered as such in clinical practice and future research.

Self‐stigma and quality of life among people with psychosis: The protective role of religion

“…In our preliminary regression analyses, QOL was found to differ by sex; males had lower scores in the psychological and social relationships domains than their female counterparts. While these findings seem to be in direct contradiction with studies demonstrating the opposite pattern (Dubreucq, Plasse, Gabayet, et al, 2021;Teh et al, 2008), or no pattern at all (Rotstein et al, 2022;Shafie et al, 2021), a plausible explanation for this discrepancy is one that takes sex differences in premorbid functioning into account. Compared to females, males have been shown to have lower levels of premorbid functioning (Rabinowitz et al, 2002), which is defined as 'social, interpersonal, school and work functioning in the period before the onset of psychosis' (Addington & Addington, 2005), and adjustment (Preston et al, 2002).…”

Gender Differences in Psychiatric Symptoms and the Social Functioning of 610 Patients with Schizophrenia in Urban China: A 10-Year Follow-Up Study

“…[15][16][17][18] Some studies indicate that female patients have a more favorable prognosis than male patients, including fewer hospital readmissions, fewer negative symptoms, and less disability. [19][20][21] In contrast, male patients with schizophrenia have been found to have significantly higher levels of positive symptoms and slightly lower levels of functioning. 22 Beyond symptoms, personal and social functioning are important outcomes for patients with schizophrenia.…”

Investigating gender differences in quality of life and social support in patients with severe mental illnesses

“…However, some other studies did not find a significant relationship between gender and the QoL of schizophrenia patients (Desalegn et al, 2020b; Hsiao et al, 2012; Shafie et al, 2021). The lower QoL in males with schizophrenia could be attributed to their higher risk and more severe course of the disorder (Rotstein et al, 2022). Li et al (2017) suggested that their societal responsibilities and roles, particularly in supporting their families, may contribute to poorer QoL in Chinese male patients with schizophrenia.…”