Gender Differences in Affective, Schizoaffective, and Schizophrenic Disorders

Abstract

This study examines gender differences in the clinical profiles and long-term outcomes of chronic DSM-III Axis I psychotic inpatients from the Chestnut Lodge followup study. Diagnostic groups include schizophrenia, schizoaffective psychosis, and unipolar affective disorder. Sex differences were frequent, especially in schizophrenia. Females with schizophrenia, for example, had superior premorbid social, sexual, and marital adjustments. They presented at index hospitalization with more depression, self-destructive behaviors, and troubled interpersonal relationships. Their long-term outcomes were better than males in terms of social activity, work competence, time symptomatic, substance abuse, and marital and parental status. Baseline gender differences were comparatively sparse for the schizoaffective and unipolar cohorts. Outcome differences were virtually nonexistent among the schizoaffective patients but unipolar females received better ratings than males in work competence and substance abuse. Females had a later onset of illness and males presented with more antisocial behaviors across all three diagnostic groups. Results highlight the importance of analyzing data by gender in studies of the psychotic disorders.

Affective empathy in schizophrenia: a meta-analysis

“…For example, we could not assess gender as a moderator because most studies used gender-matching, which would obfuscate potential gender differences in a meta-analytic framework (e.g., using the percent female of the sample as a predictor). Given that females in the general population are more empathic (Derntl et al, 2010;Schulte-Rüther et al, 2008), and females with schizophrenia have better social functioning (Andia et al, 1995;McGlashan and Bardenstein, 1990;Usall et al, 2002), gender could be an important variable to study in relation to affective empathy in schizophrenia. We also could not assess the importance of testing environment -though some studies administered tasks while conducting fMRI scans (Benedetti et al, 2009;Derntl et al, 2012a;Lee et al, 2010), this group was too small to conduct categorical moderator analyses (Fu et al, 2011), preventing examination of the effects of a potentially stressful scanning environment on performance.…”

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

“…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).…”

Gender differences in incipient psychosis

“…In contrast, studies have shown that women manifest more affective symptoms, atypical and cyclical forms of psychosis as well as a higher incidence in the diagnosis of paranoid and disorganized subtypes 4,44,45 . Szymanski et al 45 observed less illogical thinking but more anxiety, inappropriate affect and bizarre behaviour in women than men with first psychotic episode.…”

“…The first refers to the expression of symptoms and social behaviour in schizophrenic patients. Males show a higher frequency of negative psychotic symptoms, whilst females, have a higher probability of showing affective symptoms 4,5 ; usually, women with schizophrenia are more active and have a wider social network than affected men, who, in turn, are more passive and have social difficulties 6,7 . The neurobiological dimension could include four hypotheses regarding gender differences in schizophrenia: a) the estrogen hypothesis postulates a protective effect by estrogens in the development of schizophrenia in women which could explain certain gender differences in the manifestation of the disease 8 .…”