Sex differences in schizophrenia: Timing or subtypes?

Abstract

Evidence for sex differences in the epidemiology, symptom expression, and premorbid social competence of schizophrenia is reviewed. The data present a general picture of poor premorbid competence, early onset, typical schizophrenia in men, and good premorbid competence, late onset, atypical schizophrenia in women. Two main competing models emerge to account for these sex differences: a timing model and a subtype model. Other interpretations including misdiagnosis of affective disorders as schizophrenia and the overlay of general sex-role styles on psychopathology are also examined.

Schizophrenia: From the brain to peripheral markers. A consensus paper of the WFSBP task force on biological markers

“…Patients with early onset and prominent negative symptoms might be etiologically associated with a deficiency of relevant autoimmunity, since early onset schizophrenia seems accompanied by prominent clinical decline reflected by progressive neuroradiological changes, indicative of neuronal loss (Bellino et al 2004;Sato et al 2004). This contrasts to the later onset and less prominent negative symptoms in female patients, which are thought to exhibit a more active autoimmune system than males (Lewine et al 1981). In patients with schizophrenia a decrease in myelin basic protein (MBP)-specific autoantibody reactivity is proposed compared to population sontrols (Jankovic et al 1991).…”

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) .…”

Comorbidity of a Serious Mental Illness with an Addiction to Psychoactive Substances

“…Lewine (1981) in his review of the literature devoted to the differences between men and women suffering from schizophrenia emphasises that men are characterized by poorer premorbid social functioning, earlier age of first hospitalisation, more severe negative symptoms, more severe disease. Better premorbid functioning of women with schizophrenia is an element often emphasised in the literature.…”