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1.
According to the literature, schizophrenia begins in men earlier than in women. It has been argued that the gender-bound age difference is due to the protective antidopaminergic effect of estrogens in women. However, the effect of gender on the age of onset may vary between different types of schizophrenias, and can also be modulated by marital status and by age at onset of illness. Comprehensive data were collected on 3306 DSM IIR schizophrenia patients, aged 15-64 years, who had been discharged from psychiatric hospitals in Finland in 1982, 1986 and 1990. The age of onset of illness (AOI) was defined by the age at the first admission (AFA). Male patients were admitted earlier than female patients, and a small second peak in women appeared at the age of 40-44. However, there were no gender differences in AFA within diagnostic subgroups, except in paranoid schizophrenia in which AFA was lower in men than in women even when marital status was taken into account. Within paranoid schizophrenia, this effect of gender was significant only in those of the patients whose AFA was higher than 30 years. It is suggested that there is no gender difference in AOI in early onset schizophrenia. In later onset, paranoid schizophrenia, the illness seems to manifest in women later than in men.  相似文献   

2.
When and how does schizophrenia produce social deficits?   总被引:1,自引:0,他引:1  
The present study is an empirical contribution to the controversy over whether the poor social performance and lower social class of schizophrenic patients are consequences of the illness, consequences of changes in the individuals predisposed to develop schizophrenia or are due to the adverse social conditions that lead to schizophrenia. The study focuses on the socioeconomic status at onset, on the performance of social roles in the early course of schizophrenia by taking age, gender and the individual level of social development into account. In a representative sample of 232 first episodes of schizophrenia age and type of onset, type and accumulation of symptoms and social functioning in the prodromal and the psychotic prephase and at first admission were assessed and analysed for their predictive power concerning social disability 2 years after first admission. In a case-control study expected and observed social functioning from onset until first admission were compared. The subsequent course was followed up prospectively in five cross sections until 2 years after first admission. In women the age at onset was significantly higher than in men, whereas symptomatology and type of onset showed no gender differences. In 73% of the sample the prodromal phase covered 5 years on average, and the psychotic prephase (until the maximum of positive symptoms) 1.1 years. Deficits in social functioning occurred predominantly during the prodromal and the psychotic prephase. The course over 14 years showed stable group trends in social and symptom measures. By the end of the prodromal phase it was possible to predict social disability 2 years after first admission with a correct classification of 81%. The main factor determing social outcome appeared to the the acquired social status during the prodromal phase of the disorder. The unfavourable early course in men was due mainly to their significantly lower age at onset. These results raise questions concerning an earlier therapeutic and rehabilitative intervention.  相似文献   

3.
Age at onset in a cohort of schizophrenics in Nigeria.   总被引:1,自引:0,他引:1  
Over a period of 3 years, 340 patients (199 men and 141 women) who met DSM-III-R criteria for schizophrenia and who knew their exact date of birth were interviewed to determine the age at onset of illness. The immediate family's first awareness of psychotic symptoms was used as the index of onset. Men had a significantly earlier mean age at onset (24 +/- 6) than the women (27 +/- 8). By the time they were 30 years of age, 83% of the men and 66% of the women had become ill. The findings are remarkably similar to those of an earlier report in the same cultural setting, and add to the evidence of sex differences in age at onset of schizophrenia.  相似文献   

4.
Summary Schizophrenia is a disease characterized by a distinctly higher age at onset and at first admission in females than in males. In a systematic study on gender differences in schizophrenia we have confirmed this finding using different sets of data, in particular through the examination of a large and representative sample of first-admitted patients. The question addressed in this paper is whether marital status influences this sex-specific age difference. Assuming that marriage or a stable relationship is a protective factor in schizophrenia, delaying the onset of the disease or first hospitalization, the hypothesis was formulated that the later age of onset in women is at least partly explained by their generally earlier age of marriage. Testing this hypothesis illustrates some of the methodological problems that often occur when a causal analysis of social data is attempted. The problems emerge especially when both the dependent variable (age of onset/first admission) and the independent variable (marital status) are essentially related to age. First results appearing to indicate an influence of marital status on age at first admission did not bear a critical interpretation.The present study was part of the investigation Gender differences in age at onset, symptomatology and course of schizophrenia conducted within the Sonderforschungsbereich (Special Research Branch) 258 at the Central Institute of Mental Health, Mannheim. We thank the Deutsche Forschungsgemeinschaft (German Research Association) for supporting the Sonderforschungsbereich.  相似文献   

5.
Gender and schizophrenia: age at onset and sociodemographic attributes.   总被引:1,自引:0,他引:1  
A consecutive series of 214 patients (125 males, 89 females) who met the Research Diagnostic Criteria for schizophrenia were studied to determine gender differences in age at onset of the illness and sociodemographic attributes. The immediate family's first awareness of psychotic symptoms or signs and age at first presentation in hospital were used as indices of onset; male patients had a significantly earlier age of onset than females. By the time they were 30 years of age, 83% of male patients had already become ill and only 66% of females had done so. Significantly more females than males were married at the time of first contact with hospital. Married males did not differ from married females in age at onset of illness, suggesting that patients who marry may have late onset.  相似文献   

6.
OBJECTIVE: The aim of this study was to determine whether puberty plays a mediating role in onset of schizophrenia. The hypothesis was that there is an inverse relation between age at puberty (menarche) and age at onset in women. METHOD: Competent and consenting individuals with DSM-IV-defined schizophrenia or schizoaffective disorder and their mothers underwent a 45-minute interview to ascertain age at first odd behavior, age at first psychotic symptoms, age at first hospitalization, and ages at various indices of puberty. Information about substance use, head injury, perinatal trauma, and first-degree family history of schizophrenia was also obtained. RESULTS: In the women (N = 35), the earlier the age at menarche, the later the ages at both the first psychotic symptoms and the first hospitalization. There was no significant association between puberty and onset in the men (N = 45). Other than gender, none of the examined variables played a role in the interaction of puberty and onset of illness. CONCLUSIONS: In women, early puberty (whether through hormonal or social influence) was associated with later onset of schizophrenia. This effect was not found in men; in fact, the trend was in the opposite direction.  相似文献   

7.
The ABC schizophrenia study aims at investigating sex differences in age of onset, symptoms and course of schizophrenic and paranoid disorders. For this purpose, we used case register data from Denmark and Mannheim and a directly examined sample of first admissions (ABC sample). The Danish case register sample included less clinical diagnoses of schizophrenia and more schizophrenia-related disorders (acute paranoid reaction, paranoid states and borderline schizophrenia) than the Mannheim data (case register and ABC sample). The problem therefore was whether the two datasets are comparable and the results are valid. For this reason a randomized, stratified sample of 116 patients was drawn from the Danish case register sample. The case notes of these 116 patients were requested from the hospitals where the patients had been treated and analyzed by means of a scoring sheet based on the Interview for the Retrospective Assessment of the Onset of Schizophrenia (IRAOS). The use of operationalized diagnoses of the CATEGO program, based on PSE items, which are integrated in IRAOS, demonstrated that the samples of the Danish and the Mannheim case registers and the directly investigated ABC sample have comparable diagnostic distributions. Possible explanations for the differences between the clinical and the CATEGO diagnoses in the Danish case register may be the frequent use of diagnoses of borderline schizophrenia and reactive psychoses (previously called psychogenic psychoses), and above all a more narrow concept of schizophrenia; in Denmark, schizophrenia is diagnosed relatively late, i.e., after the presence of enduring negative symptoms, and thus mostly after the appearance of residual state. These diagnostic preferences may help to explain the fall in first admission rates for schizophrenia – above all in women – in Denmark and the low incidence rates of schizophrenia by first contact within the WHO determinants of outcome study. The earlier hospitalization of men could be replicated as well as the course of treatment (readmissions and discharges) of schizophrenic men and women over 10 years after first admission.  相似文献   

8.
To evaluate the impact of familial loading and gender on age at onset, 197 schizophrenic patients were investigated. Patients with familial loading had an earlier age at onset without gender differences. In contrast, an earlier age at onset for men was found in sporadic cases. These data support that both gender and familial loading contribute to the heterogeneity of schizophrenia.  相似文献   

9.
Empirical studies have shown that there are differences between women and men with respect to the onset of schizophrenia and the development of their mental and social conditions. It was therefore the goal of this study to assess the objective life situation and subjective quality of life, as well as the differences, similarities and interrelations, at the onset of schizophrenia in women and men. Ninety schizophrenic patients were interviewed between the second and fourth weeks of their first hospital stay using the Berlin Quality of Life Profile, and rated according to the BPRS. Areas of social problems (work, living circumstances, safety and drug abuse) had become manifest with several of the patients, particularly among the young men, prior to first admission. Although objective conditions, gender and psychopathology have an impact on the subjective quality of life, it cannot be fully explained by them. Multivariate analyses have demonstrated that the factors influencing it are probably different for women and men, and schizophrenic women appraise their life circumstances in a different manner from men, as is true for differences between the statements of acutely and chronically ill patients. It can be concluded from the results of this study that psychiatric services should offer specific social support measures before or at first hospital admission and not after the illness has become chronic. The subjective construct of global quality of life apparently differs from one sample to another, and gender-related aspects, among others, have an impact on it. Received: 2 June 1997 / Accepted: 14 July 1998  相似文献   

10.
Whether there is a specific link between certain delusional symptoms and particular etiologies has not yet been completely clarified. In this study, 639 first ever admitted deluded patients were investigated in order to find out whether age and gender are associated with certain delusional contents, whether age at first admission may be linked to certain etiologies and whether it is possible to detect indicators particularly related to basic dysfunctions. At first admission, delusional female patients were older than men with a significant predomination of delusions of persecution, while men presented significantly more frequently delusions of jealousy and grandiosity. Within delusions of persecution, of religious or metaphysical content and of grandiosity, women were even significantly older than men. Religious or metaphysical and grandiosity contents occurred significantly more frequently in ICD-8 schizophrenia, indicating that these themes seem to be particularly linked to ICD-8 schizophrenia. Additionally, some target symptoms not included in the delusional symptomatology were investigated to test the relationship between delusions and schizophrenia. Overall, the results of the present investigation indicate that delusions are not specific for schizophrenia, and therefore, other symptomatological criteria should be applied for the nosographic attribution.  相似文献   

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