Gender differences in the clinical expression of schizophrenia

Shtasel, Derri; Gur, Raquel E.; Gallacher, Fiona; Heimberg, Carolyn; Gur, Ruben C.

doi:10.1016/0920-9964(92)90016-x

Cited by 152 publications

(79 citation statements)

References 34 publications

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“…Although the observed differences in symptoms and functioning did not remain significant after Bonferroni correction for multiple comparisons, they were exactly as predicted a priori, and they support the large literature in the field indicating that there are differences in the clinical presentation of male and female participants with psychotic disorders (Angermeyer, Kühn, & Goldstein, 1990;Bardenstein & McGlashan, 1990;DeLisi et al, 1989;Goldstein & Link, 1988;Grossman et al, 2006;Hambrecht et al, 1992;Lindamer et al, 2003;Shtasel et al, 1992;Usall et al, 2003). These findings suggest that underlying differences may predate the onset of psychosis.…”

Section: Discussionsupporting

confidence: 74%

“…Studies have consistently shown there are gender differences in age of onset, severity of negative symptoms, long-term functioning and social support for patients with schizophrenia (Angermeyer, Kühn, & Goldstein, 1990;Bardenstein & McGlashan, 1990;DeLisi et al, 1989;Goldstein & Link, 1988;Grossman et al, 2006;Hambrecht et al,1992;Lindamer et al, 2003;Shtasel et al, 1992;Usall et al, 2003). Some of these differences have also been observed in individuals with schizotypal personality disorder and other schizophrenia spectrum disorders Gurrera et al, 2005).…”

Section: Introductionmentioning

confidence: 92%

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Gender differences in symptoms, functioning and social support in patients at ultra-high risk for developing a psychotic disorder

Willhite

Niendam

Bearden

et al. 2008

Schizophrenia Research

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Gender differences have been widely observed in the clinical presentation, psychosocial functioning and course of illness in first episode and chronic patients suffering from schizophrenia. However, little is known about gender differences in the psychosis prodrome. This study investigated gender differences in symptoms, functioning and social support in individuals at ultra-high-risk for developing a psychotic disorder. Sixty-eight ultra-high-risk patients were assessed at baseline, and twenty-seven returned for follow-up assessments approximately six and twelve months later. Clinical symptoms and functioning were assessed by clinical interview; social support was measured using a self-report questionnaire. There were no gender differences in demographic variables, symptoms or functioning at baseline. Males were found to have significantly higher levels of negative symptoms and marginally lower levels of functioning when baseline and follow-up time points were considered collectively. Additionally, females reported higher levels of social support at baseline. Differences in negative symptoms were found to mediate differences in functioning between male and female patients. This study suggests that gender based differences in symptom presentation and functional outcome may predate conversion to psychosis. Follow-up studies should examine the relationship between symptoms, functioning and social support in this population.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 92%

Gender differences in symptoms, functioning and social support in patients at ultra-high risk for developing a psychotic disorder

Willhite

Niendam

Bearden

et al. 2008

Schizophrenia Research

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“…We addressed this issue by assessing a sample who were young when first evaluated (23 years old), and who were most often (76%) undergoing their first or second hospitalization. Thus the women with schizophrenia included many whose first break occurred early for women, since many women with schizophrenia experience their first break in their mid-to-late 20s (10,(50)(51)(52). The current study involves seriously ill women with schizophrenia, and compares these women with men whose first break occurred at an age more typical for men.…”

Section: Discussionmentioning

confidence: 99%

“…For example, women with schizophrenia have been reported to have fewer negative symptoms (8)(9)(10)(11), better responses to neuroleptics (12), better social functioning (13)(14)(15)(16), and less time in the hospital (1). However, in other studies, no sex differences have been found in negative, affective, and psychotic symptoms (17)(18)(19), neurocognitive functioning, MRI findings (20), and number and duration of hospitalizations (21).…”

mentioning

confidence: 99%

Sex differences in schizophrenia and other psychotic disorders: a 20-year longitudinal study of psychosis and recovery

Grossman

Harrow

Rosen

et al. 2008

Comprehensive Psychiatry

142

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This longitudinal study was designed to provide data on sex differences in the course of illness in schizophrenia and other psychotic disorders. Ninety-seven participants (43 women and 54 men) were assessed during index hospitalization when they were in the acute phase of illness, and then reassessed prospectively at 6 consecutive followups over a 20 year period. Patients were evaluated by a series of standardized measures on many aspects of illness including the presence of psychosis, global outcome, and rate of recovery. When women were compared to men in this sample, the data demonstrated a lower percentage of psychotic activity for women over the course of illness (significant at the 7.5 and 20 year followups), and a significant improvement in psychotic activity over 20 years for women (p<.05), but not for men. Additionally, women showed significantly better global functioning (p<.05) at 3 of the 6 followups (the 2, 7.5, and 10-year followups). Significantly higher percentages (p<.05) of women were in recovery at 2 of the 6 followup years (the 2 and 10-year followups). Cumulatively, 61% of the women with schizophrenia showed a period of recovery at some point during the 20 year period, compared to 41% of the men. The sex difference patterns were similar for patients with schizophrenia and for those with other types of psychotic disorders. Sex differences in this sample were specifically not attributable to differences in age of onset or premorbid developmental achievements.

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“…Assessment of Negative Symptoms (SANS, Andreasen, 1983), and the Scale for Assessment of Positive Symptoms (SAPS, Andreasen, 1984) by investigators trained to a criterion reliability of 0.90 intraclass correlation (Shtasel et al, 1992b). These scales were administered both at intake and at repeated 6-month intervals in longitudinal follow-up, one of which corresponded with the 19-month follow-up analyzed for the current study.…”

Section: Assessment Scales-clinical Symptomatology Was Assessed With mentioning

confidence: 99%

Neuropsychological evidence supporting a neurodevelopmental model of schizophrenia: a longitudinal study

Censits

Ragland

Gur

et al. 1997

Schizophrenia Research

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255

142

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The stability of neuropsychological performance in schizophrenia and its relationship to clinical change was contrasted between 60 patients with schizophrenia (30 first-episode, 30 previously treated) and 38 healthy controls using a comprehensive neuropsychological battery and clinical scales administered at intake and at a 19-month follow-up. Consistent with the neurodevelopmental model of schizophrenia, patients demonstrated deficits in cognitive performance at initial testing and did not show decline at follow-up. There were no differences in neuropsychological performance over time between first-episode and previously treated patients, nor between male and female patients or controls. As expected, patients improved clinically with treatment with respect to both positive and negative symptoms. First-episode patients improved more on the positive symptoms of hallucination and delusion; male and female patients showed equivalent clinical improvement. Clinical improvement correlated positively with neuropsychological change, with improved negative symptomatology accounting for most of the significant correlations.

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Gender differences in the clinical expression of schizophrenia

Cited by 152 publications

References 34 publications

Gender differences in symptoms, functioning and social support in patients at ultra-high risk for developing a psychotic disorder

Gender differences in symptoms, functioning and social support in patients at ultra-high risk for developing a psychotic disorder

Sex differences in schizophrenia and other psychotic disorders: a 20-year longitudinal study of psychosis and recovery

Neuropsychological evidence supporting a neurodevelopmental model of schizophrenia: a longitudinal study

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