Sex differences in schizophrenia

Schizophrenia is diagnosed in more men than women, with a male to female ratio of 1.4:1. Women are more likely than men to experience an emergence of psychotic features later in life. Women tend to display more emotional and psychotic symptoms than men. Researchers are finding that gender is also useful in understanding schizophrenia.

According to the DSM-V, women diagnosed with schizophrenia are more likely than men to experience the first major symptoms of the disorder at a later age. Women often experience more emotional and psychotic symptoms while men tend to have more disorganization and negative symptoms. Women tend to show a worsening of psychotic symptoms as they age. Men tend to have greater social impairment from their symptoms.

Although these trends have been observed, men and women living with this disorder still may vary significantly from their sex while still meeting the criteria for the schizophrenia diagnosis.

Children diagnosed with childhood-onset schizophrenia, a rare form of schizophrenia with an onset of psychotic symptoms prior to adolescence, have very few sex differences. Males tend to have a younger age of onset by about one year. Females tend to have lower verbal IQ scores at this age.

Onset is most common for men and women between late teens and mid-30's. Females are most prone experience their first psychotic episode at late 20's, and males their mid 20's.

During middle age, more women than men experience onset of schizophrenia. The reason for this phenomenon is unknown. Theories include differential brain aging to explain the consistent lag of onset in females compared to men as well as hormone depletion during menopause, citing the anti-psychotic nature of estrogen.

Most men diagnosed with schizophrenia do not marry and have limited social networks. Women diagnosed with schizophrenia, especially in cases of late onset, are more likely than men to be married.

Women diagnosed with schizophrenia tend to have fewer offspring than those not affected; however, this difference is less pronounced than men. Women diagnosed with schizophrenia often experience pressure from their community to not have children due to their mental disorder.

The first hospital admission in people with schizophrenia tends to be at a younger age in males than in females, regardless of age of onset. The first manifestations of schizophrenia may occcur at the same age in both males and females, but the time that elapses between onset and first admission to a hospital is considerably shorter in males than in females. Gender differences in age at the first hospital admission are typically due to a more acute onset in females.

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Wikipedia