Towards better care for women with schizophrenia-spectrum disorders

Brand, Bodyl A; Boer, J N de; Dazzan, Paola; Sommer, Iris

doi:10.1016/s2215-0366(21)00383-7

Cited by 30 publications

(23 citation statements)

References 75 publications

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“…Previous studies have shown that the serum concentrations of most antipsychotics in premenopausal women are higher than in men, or if the serum concentrations are the same, the share of the dopamine receptors is higher in women than in men. [18][19][20][21] However, there are no gender-specific dosing recommendations in clinical practice, leading to unavoidable risks of overmedicating. A more comprehensive appreciation of the role of gender in the molecular basis of schizophrenia will encourage the development of novel and more effective pharmacotherapies.…”

Section: Disease Managementmentioning

confidence: 99%

“…Due to the different physical structures of males and females, the pharmacodynamics and pharmacokinetics of antipsychotics may also be affected by gender. Previous studies have shown that the serum concentrations of most antipsychotics in premenopausal women are higher than in men, or if the serum concentrations are the same, the share of the dopamine receptors is higher in women than in men 18–21. However, there are no gender-specific dosing recommendations in clinical practice, leading to unavoidable risks of overmedicating.…”

Section: Disease Managementmentioning

confidence: 99%

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A glimpse of gender differences in schizophrenia

Zhou

2022

Gen Psych

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Section: Disease Managementmentioning

confidence: 99%

Section: Disease Managementmentioning

confidence: 99%

A glimpse of gender differences in schizophrenia

Zhou

2022

Gen Psych

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“…[10][11][12] Studies that focus on gender differences are important for understanding the biological, psychological, and sociological processes of schizophrenia, and provide clues for precise treatment of male and female patients. 13,14 For example, gender differences in clinical presentation, psychosocial functioning, and course of illness have been widely observed in patients with schizophrenia. [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.…”

Section: Introductionmentioning

confidence: 99%

“… 10–12 Studies that focus on gender differences are important for understanding the biological, psychological, and sociological processes of schizophrenia, and provide clues for precise treatment of male and female patients. 13 , 14 For example, gender differences in clinical presentation, psychosocial functioning, and course of illness have been widely observed in patients with schizophrenia. 15–18 …”

Section: Introductionmentioning

confidence: 99%

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

Zhao¹,

Diao²,

Li³

et al. 2022

NDT

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To explore the different outcomes between male and female patients with schizophrenia after long-term follow-up. Patients and Methods: Schizophrenia patients were participants in our study. First, two senior psychiatrists collected data on the demographic characteristics and clinical symptoms of patients from the Hospital Information System between February 2009 and January 2010. Second, two other senior psychiatrists called the patients and their guardians between February 2019 and January 2020 to get general information on the patients and assess their psychiatric symptoms and social functioning using the Positive and Negative Syndrome Scale (PANSS) and the Personal and Social Performance (PSP) scale. Results: Of the 610 participants, the 306 female participants were younger (48.32 ± 12.99 vs 49.84 ± 12.60) and had received more education (8.08 ± 3.76 vs 7.94 ±3 0.73). After 10 years, women were found to have more outpatient visits than men (20.86 ± 22.21 vs 16.11 ± 16.87, P < 0.05). However, there was no significant gender difference in number of hospitalizations (3.12 ± 5.34 vs 2.77 ± 5.84, P > 0.05). The PANSS scores were lower for both groups at the 10-year follow-up. Women had significantly lower scores than men after the 10-year period (P < 0.05). With regard to social functioning, there was a significant difference in social functioning between baseline scores and 10-year follow-up scores indicating an improvement in social functioning. PSP scores had significantly increased in women (P < 0.01) but not in men (P > 0.05). Conclusion: Female patients had significantly lower levels of psychiatric symptoms and higher levels of social functioning at 10-year follow-up than male patients. They also reported more outpatient visits, which may have contributed to the gender differences in outcomes. Family members and doctors of patients should urge patients to make regular outpatient visits for better outcomes after hospitalization.

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“…Another confirmatory finding is that early puberty in girls (but not in boys) is associated with relatively later onset of symptoms in young people who go on to develop schizophrenia [ 36 , 37 , 38 ]. It is also known that symptoms fluctuate over the menstrual cycle in women with schizophrenia, increasing in severity when estrogen levels are low [ 29 , 39 ]. At postpartum, when estrogen levels precipitously drop, women with schizophrenia often relapse [ 40 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Menopause on Antipsychotic Response

2022

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Background: It has been hypothesized that, whenever estrogen levels decline, psychosis symptoms in women increase. At menopause, this can happen in two main ways: (a) the loss of estrogen (mainly estradiol) can directly affect central neurotransmission, leading to increase in schizophrenia-related symptoms, and (b) the loss of estrogen can decrease the synthesis of enzymes that metabolize antipsychotic drugs, thus weakening their efficacy. Aims and Methods: The aim of this narrative review was to investigate the second possibility by searching PubMed and ClinicalTrials.gov for studies over the last two decades that investigated the metabolism of antipsychotics and their efficacy before and after menopause in women or that studied systemic and local estrogen level effects on the pharmacokinetics and pharmacodynamics of individual antipsychotic drugs. Results: The evidence suggests that symptom level in women with schizophrenia rises after menopause for many reasons beyond hormones but, importantly, there is an estrogen-dependent loss of efficacy related to antipsychotic treatment. Conclusion: Effective clinical intervention is challenging; nevertheless, several promising routes forward are suggested.

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Towards better care for women with schizophrenia-spectrum disorders

Cited by 30 publications

References 75 publications

A glimpse of gender differences in schizophrenia

A glimpse of gender differences in schizophrenia

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

The Effect of Menopause on Antipsychotic Response

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