The effect of sex, marriage and age at first admission on the hospitalization of schizophrenics during 2 years followings discharge

Abstract

SYNOPSIS Two hundred and eighty-two schizophrenics discharged from St John's Hospital, Stone, were followed-up. The reliability of the diagnosis was measured by the extent of agreement among the hospital clinicians. The number of readmissions and the time spent in hospital were ascertained and correlated with the sex, civil state and age at first admission of the subjects.It was found that a higher proportion of males than of females was readmitted; that the proportion of single persons among male schizophrenics is higher than among comparable age groups in the general population; that single males are more frequently admitted than single females; that the peak age of first admission for males is 10 years earlier than for females and that men whose age at first admission is below the median are more frequently readmitted than those whose age at first admission is above it.Women are more frequently married than men at the onset of schizophrenia, giving rise to the suggestion that marriage has a protective effect in schizophrenia. This hypothesis was not supported by our findings. The bearing of these findings on the course, genetics and marital handicap of schizophrenia is discussed. INTRODUCTIONprobably received most attention.During 1929-31 The significance of the effects of age at onset, sex i n N e w Y o r k State > Malzberg (1935) found the and marriage in schizophrenia lies in the insight first admission rate greater for males than for they afford to the interaction of biological and females but the rate considered at different age social processes affecting it and their bearing on P e r i o d s d i f f e r e d considerably between the sexes, aetiology and outcome. Studies of the effect of F r°m 1 4 t o 2 4 y e a r s t h e m a l e r a t e r o s e r a P l d l y t o these variableson outcome have produced varying a maximum of 52 per 100000 at 20-24 and thereresults, as shown in Tables 1 and 2, where from af *er decreased. Female rates were lower and various sources the effect of sex and age of onset r e a c h e d a l o w e r maximum more slowly: 35 per on outcome of schizophrenia is categorized ac-1 0 0 0 0° a t 3 5~3 9 y e a r s -T h e married had a cording to whether each is favourable or un-markedly lower first admission rate (23 per favourable. The variability in results can be 100000) than the single (97 per 100000); the rate attributed in part to the different criteria of out-f°r single males was higher but for married males come adopted and the unreliability of the diag-l o w e r t h a n f o r corresponding groups of females, nosis of schizophrenia. If hospitalization is T h e s e r e s u I t s h a v e b e e n confirmed for other adopted as the criterion of outcome, it can Pl ac es and t.mes by Oedegaard (1946) for the conveniently be considered at 3 stages: admission, population of Norway

Schizophrenia in Rural Ireland: a Case of Service Overutilisation

“…The largest number of admissions (77 % Clare, 68 % Wexford) were single individuals, predominantly male 52 % Clare and 44 % Wexford). The low number ofadmittants who were married (18% Clare and 24 % Its consistent with the research suggesting marital status may have a buffering effect on psychiatric hospitalisation (Tischler et al 1975;Watt & Szulecka, 1979). Both counties had a low number of first admittants who were widows (5 % Clare and 6 % Wexford).…”

The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics

“…The earlier age of onset in males has been repeatedly reported in large-scale studies of schizophrenics (Malzberg, 1935;Landis & Page, 1938;Rennie, 1941;Shepherd, 1957;Rosenthal, 1961;Brown et al 1966;Kay, 1972;Forrest & Hay, 1972;Nystrup, 1976;Watt & Szulecka, 1979;Lewine, 1981;Loranger, 1984;Sartorius et al, 1986). Lewine (1980), in a study of 97 cases, found that this could not be accounted an artefact as a result of a difference in the interval between the onset of symptoms and admissions to hospital, nor by diagnostic discrepancies since it was present when both broad and narrow criteria are employed .…”

“…Shepherd (1957) reported that more schizophrenic males are unmarried than in any other diagnostic category. Single schizophrenic men are more often readmitted than single women, a difference which does not occur between married male and female schizophrenics (Watt & Szulecka, 1979).…”

“…Stevens (1969) reports that those women with schizoid characteristics and an insidious onset of the disorder are significantly less likely to marry than those with either an unstable mood or a normal pre-morbid personality. A comparison of the proportion of unmarried schizophrenics with the proportion of unmarried persons in the age-standardized general population shows, however, that there is a significant excess for males but not for females (Watt & Szulecka, 1979). Shepherd (1957) reported that more schizophrenic males are unmarried than in any other diagnostic category.…”

Toxoplasma gondii and Schizophrenia: A Relationship That Is Not Ruled Out

“…• Initial symptoms in both diseases commonly manifest between the second and third decade of life [27,28].…”