Gender differences in early onset of chronic physical multimorbidities in schizophrenia spectrum disorder: Do women suffer more?

Abstract

AimThe association between various physical illnesses and schizophrenia spectrum disorder (SSD) is well‐established. However, the role of gender remains unclear. The present study explored the gender‐based differences in the prevalence and early onset of chronic physical multimorbidities (CPM) in patients with SSD and the general population (GEP).MethodsWe recruited 329 SSD patients and 837 GEP controls in this nested cross‐sectional study. The primary outcome was the prevalence of the chronic physical multimorbidities, especially in the youngest age group (<35 years).ResultsWomen with SSD had more than double the odds for having CPM than men (OR = 2.47; 95% CI 1.35‐4.50), while the gender‐related burden of chronic diseases in controls was nearly the same (OR = 0.89; 95% CI 0.65‐1.22). Furthermore, the prevalence of chronic disease in younger women patients was significantly higher than in controls (P = .002), while younger men did not seem to experience this increased comorbidity burden.ConclusionsThis study suggests that women with SSD are at increased physical comorbidity risk compared to men, particularly early in the course of psychiatric illness. Tailored and individualized treatment plans must consider this, aiming to deliver holistic care and effective treatment outcomes.

Women with Schizophrenia over the Life Span: Health Promotion, Treatment and Outcomes

“…Altogether, women appear to enjoy a better quality of life, show fewer negative symptoms and exhibit less social and clinical disability than men [13]. Nevertheless, in terms of physical health, their comorbidity risk is relatively higher [14].…”

“…Likewise, symptoms lessen when hormone levels rise, namely during the mid-luteal stage of the menstrual cycle and over the course of pregnancy [17]. Some studies have found that premorbid estrogen levels in women who later develop schizophrenia are already lower than they are in the general population [14], which further implicates estrogen in the pathogenesis of this disease.…”

Gender Differences in Clinical and Psychosocial Features Among Persons With Schizophrenia: A Mini Review

“…Studies investigating gender differences with respect to life expectancy in patients with schizophrenia reported either a lack of difference in the mortality ratio of patients with schizophrenia vs. the general population ( 110 – 112 ) or a greater reduction of life expectancy with respect to the general population in male vs. female patients with schizophrenia ( 113 – 115 ). A higher frequency of cardiovascular death has been found in male ( 3 , 17 ), but also in female patients ( 116 ) as well as a higher frequency of death caused by cancer in females ( 17 ). An association between antipsychotic use and reduced all-cause, cardiovascular and suicide mortality has been reported in both genders ( 117 ).…”

Psychosis in Women: Time for Personalized Treatment

“…It can be hypothesized that the sex differences seen in outcomes may be largely affected by other risk factors (premorbid functioning, age at onset of psychosis, attrition rate and so forth) [31]. On the other hand, there is evidence that women with schizophrenia spectrum disorders have more than double the odds of having physical comorbidities than men, particularly early in the course of psychiatric illness and at younger ages (<35 years) [32]. variables assessed at baseline (first contact), 1-, 3-, and 10-year follow-ups At baseline, female age older than men, better premorbid adjustment, higher IQ, and better occupational status.…”