精神分裂症患病同胞的性别差异研究

目的：探讨精神分裂症患病同胞临床表现及预后的性别差异。方法：于1981年至2001年对51例精神分裂症异性患病同胞进行回顾性对照研究,其中男性25例,女性26例。对男女两组的有关情况进行比较。采用阳性与阴性症状量表（PANSS）评定精神症状。结果：男性患者病前社会功能差于女性,PANSS总分显著高于女性,阴性症状差异更为明显,住院时间男性明显多于女性。经5年随访,社会功能缺陷量表（SDSS）评定显示,男性残疾程度较女性严重,男性婚姻状况明显差于女性。结论：精神分裂症患病同胞在社会功能,精神症状等方面存在性别差异。     

康复训练对女性慢性精神分裂症患者疗效观察

目的探讨康复训练对女性慢性精神分裂症患者的疗效。方法将52例女性慢性精神分裂症患者分为研究组和对照组,在常规药物治疗的基础上,对研究组病人进行12周的康复训练,对照组采用传统的医疗模式,分别于研究前,研究12周后运用阳性和阴性症状量表(PANSS)和生活质量综合评定问卷(GQOLI-74)进行评定。结果训练前2组各量表评分差异均无显著性(P>0.05),训练后研究组PANSS阴性因子分,一般精神病理量表分,总分较训练前明显下降(P<0.01)。研究组的生活质量综合评定问卷总分及各维度评分均高于对照组(P<0.01)。结论康复训练可改善女性慢性精神分裂症患者的临床症状和生活质量。     

分级开放管理对男性精神分裂症长期住院患者生活质量的影响

目的研究不同分级开放管理对长期住院男性精神分裂症患者生活质量的影响。方法120例精神分裂症患者分为室内开放（A组）、院内开放（B组）、院外开放（C组）三组,每组40例,于基线时、开放3月末、开放6月末评定精神分裂症患者生活质量量表（SQLS中文版）、住院精神病患者社会功能评定量表（SSPI）、阳性和阴性症状量表（PANSS）、检测体重、胆固醇、甘油三脂、血糖,并记录开放后不良事件发生情况。结果A组、B组、C组开放3月末、6月末与基线生活质量总分及各因子分、社会功能总分、PANSS总分均有统计学差异（P〈0．05）。开放6月末B组、C组与A组生活质量总分、心理社会因子分、症状和副反应因子分、社会功能总分、PANSS总分、阳性症状分、阴性症状分均有显著统计学差异（P〈0．01）,C组与B组PANSS总分、阳性症状分、阴性症状分均有显著统计学差异（P〈0．01）,而三组基线、开放3月末生活质量、社会功能以及PANSS总分均无统计学差异（P〉0．05）。结论开放管理可以提高长期住院男性精神分裂症患者的生活质量和社会功能,促使其精神症状改善。     

伴与不伴抑郁症状的精神分裂症患者临床特征的性别差异

目的:探讨伴与不伴抑郁症状的精神分裂症患者临床症状的性别差异。方法:纳入精神分裂症患者138例及正常对照者94名,采用阳性和阴性症状量表(PANSS)评估患者的精神症状、卡尔加里精神分裂症抑郁量表(CDSS)评估患者的抑郁症状;同时运用重复性神经心理状态测验(RBANS)评估受试者的认知功能。结果:精神分裂症伴有抑郁组PANSS总分及因子分高于不伴抑郁症状组(P均0.001),RBANS总分及因子分低于不伴抑郁症状组(P0.05或P0.01)。性别分层后,PANSS总分及因子分、RBANS总分及因子分在女性精神分裂症患者伴与不伴抑郁症状组间差异有统计学意义(P0.05或P0.01),男性伴与不伴抑郁症状组PANSS总分、阴性症状、一般精神症状分、RBANS总分及即时记忆因子分差异有统计学意义(P0.05或P0.01)。男、女精神分裂症患者CDSS分与PANSS总分呈正相关(P均0.001),而CDSS评分与RBANS总分的相关性只存在于女性精神分裂症患者中(女:r=-0.334,P=0.008)。结论:伴与不伴抑郁症状的精神分裂症患者精神症状及认知功能存在男女性别差异。     

首发和慢性精神分裂症患者神经认知功能的性别差异

目的 探讨首发未服药精神分裂症（FES）和慢性精神分裂症（CSz）患者的神经认知功能的 性别差异。方法 收集符合ICD-10 的FES 患者53 例和CSz 患者104 例，同期募集健康对照（HC）52 名。 3 组均采用MATRICS 共识认知成套测验（MCCB）中文版评估神经认知功能。结果 （1）MCCB 测验得分 性别差异比较结果显示，组别和性别的交互作用无统计学意义（F=0.80，P=0.67）；组别的主效应显著， MCCB 6 项分测验及神经认知总分差异均有统计学意义；性别的主效应在视觉学习记忆分测验差异有 统计学意义（F=5.12，P=0.03）。CSz组视觉学习记忆女性优于男性（t=2.44， P=0.02），FES 组和HC 组性别 差异无统计学意义。（2）与HC 组比较，除词语学习和记忆外，FES 和 CSz组MCCB 总分和各分测验评分 比较差异均有统计学意义。FES 与CSz 组比较，FES 组在神经认知维度总分优于CSz 组（t=2.36，P=0.05）。 结论 首发和慢性精神分裂症患者的认知功能均受损，且男性慢性患者视觉学习记忆损害较女性更为 严重。     

男性精神分裂症服刑人员教养方式与人格相关性研究

目的探讨男性精神分裂症服刑人员(schizophrenia inmates,SI)教养方式与人格相关性。方法对83例SI患者及与其人口学资料相匹配的630名精神分裂症患者作为对照组,分别进行父母教养方式量表及艾森克人格问卷进行测评。结果 (1)SI组在父母教养方式调查问卷(Egna Minnen Barndoms Uppfostran,EMBU)量表中的父亲因子Ⅰ得分高于对照组,母因子Ⅱ的得分低于对照组[(47.84±10.27)分vs(44.77±10.20)分,(35.95±6.28)分vs(34.04±7.22)分],差异有统计学意义(t=-2.581,P=0.010;t=-2.299,P=0.022);(2)SI组中父亲因子Ⅰ与EPQ量表中E量表显著相关,与N量表得分呈负相关;(3)对照组中父亲因子Ⅰ与EPQ量表中E呈正相关,与P、N得分呈负相关;母亲因子Ⅱ与E、N得分呈正相关,与L得分呈负相关,结论父亲温暖理解不能阻止男性精神分裂症患者出现违法行为,母亲过分干涉对犯罪有影响,男性精神分裂症服刑人员父母教养方式对患者人格形成的影响降低。     

非典型抗精神病药对男性精神分裂症患者性功能影响的初步分析

目的 探讨喹硫平、利培酮、奥氮平及氯氮平对男性精神分裂症患者性功能影响的差异.方法 将门诊就诊的男性精神分裂症患者145例,分为喹硫平组 30 例、利培酮组 47 例、奥氮平组 31 例及氯氮平组 37 例.检测各组患者血清泌乳素水平.使用简明男性性功能量表、阳性与阴性综合征量表(PANSS)评估性功能及精神症状,用副反应量表(TESS)评估药物治疗的不良反应.共观察8周.结果 治疗第 8 周末,利培酮组的性功能量表总分及因子分均较治疗前降低,奥氮平组的性唤起因子及性功能因子得分有所下降,氯氮平组的性满意度因子及性功能因子得分有所下降.喹硫平组得分无明显变化.利培酮组和奥氮平组治疗第 8 周末的血清泌乳素水平高于基线水平[利培酮组:(12±5)ng/ml,(20±6)ng/ml,t=13.92,P＜0.01;奥氮平组:(13±6)ng/ml,(18±5)ng/ml,t=8.27,P＜0.01],喹硫平组和氯氮平组无明显变化.影响男性精神分裂症患者性功能的因素有泌乳素、年龄及TESS分.结论 常见非典型抗精神病药物对男性精神分裂症患者的性功能影响有所不同.     

不同性别首发精神分裂症患者认知功能损害的比较

目的　探讨精神分裂症患者认知功能损害是否存在性别差异。方法　比较 1 64例首发、未服药的男女精神分裂症患者认知功能差异 ,并和性别、年龄等匹配的 1 64例健康人作对照。结果　健康组男性的语言及部分运动功能显著优于女性。而且 ,在控制健康组性别差异后 ,男性精神分裂症患者的语言、空间组织、运动功能仍显著优于女性 ;结论　本文不支持国外男性精神分裂症患者认知功能较女性差的看法。     

应用护士观察量表对精神分裂症患者冲动行为的初步研究

目的观察精神分裂症病人的冲动行为。方法将124例病人应用护士观察量表进行测定,并根据其中激惹因子得分的高低分为冲动组和非冲动组。结果冲动组,女性病人多于男性（X^2=4．65,P〈0．05）。年龄与冲动行为无显著差异。根据病史中有无冲动行为,分为观察冲动组和观察非冲动组。在激惹因子中,有5个项目两组得分有显著差异（P〈0．05）和极显著差异（P〈0．01）,观察冲动组发生冲动行为的病人明显高于观察非冲动组。结论对住院精神病人进行护士观察量表测定,有利于了解病人的激惹情绪和冲动行为,以助采取相应的护理对策,以及对医务人员的自我保护等具有一定的意义。     

产后抑郁症患者的心理社会因素分析

目的研究产后抑郁症患者的人格特征、生活事件及社会支持影响因素。方法对93例产后抑郁症患者及135名正常产妇分别应用艾森克人格问卷、生活事件量表及社会支持评定量表进行评估。结果与正常产妇相比较,产后抑郁症在人格方面具有内倾及神经质倾向,且常经历较多的负性生活事件;产后抑郁症组的社会支持总分及其各分量表得分均显著低于正常组。结论产后抑郁症的发生与人格、生活事件及社会支持等心理社会因素有关。     

男女儿童青少年精神分裂症患者临床特征的比较

目的:比较儿童青少年精神分裂症男性与女性患者临床特征的差异。方法:对125例男性(男性组)和133例女性(女性组)儿童青少年精神分裂症患者的年龄、发病年龄、病前诱因、阳性家族史、病程特点、住院天数、简明精神病量表(BPRS)、大体评定量表(GAS)及临床疗效总评量表(CGI)评分等临床特征进行比较。结果:男性与女性患者在年龄、发病年龄、病前诱因、阳性家族史、病程特点、住院天数方面比较差异无统计学意义(P均0.05)。BPRS评分中敌对性、动作迟缓、情感淡漠、缺乏活力因子分男性组高于女性组(t=2.164,t=3.317,t=2.096,t=2.230;P0.05或P0.01);幻觉、思维障碍因子分女性组高于男性组(t=3.682,t=2.987;P0.01或P0.001)。入院时GAS、CGI-SI评分及出院时CGI-GI评分两组间差异无统计学意义(P均0.05),出院时CGI-EI评分女性组高于男性组(t=2.466)、自知力评分男性组高于女性组(t=2.403),差异有统计学意义(P均0.05)。结论:男性儿童青少年精神分裂症患者的临床特征以情感淡漠、缺乏活力等阴性症状为主,女性则以幻觉、思维障碍等阳性症状更突出;女性临床疗效优于男性。     

Gender differences in cognitive deficits in schizophrenia with and without diabetes

This study investigated gender differences in cognition in schizophrenia with and without diabetes. Cognition was assessed in 263 individuals with schizophrenia with age range (40–68): 67 males and 34 females with schizophrenia with diabetes; and 125 males and 37 females with schizophrenia without diabetes according to the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Fasting glucose, hemoglobin A1c (HbA1c) and lipid levels were measured. Results showed that male individuals performed worse on most cognitive tasks, especially attention, in schizophrenia with than without diabetes. This result was not observed in female individuals. Also, individuals of both genders showed higher fasting glucose and HbA1c in schizophrenia with than without diabetes. In schizophrenia with diabetes, males had significantly worse cognition than females in all cognitive domains. Higher HbA1c, lower high-density lipoprotein, and an earlier age of onset of schizophrenia were found in males compared with female individuals. HbA1c was negatively associated with attention and the RBANS total score for males but not for females. In schizophrenia without diabetes, males showed worse performance in immediate and delayed memory than females. This study support cognition was worse for males with schizophrenia irrespective of whether they have diabetes. However, diabetes exemplified the gender differences, especially in attention.     

Gender differences in premorbid cognitive performance in a national cohort of schizophrenic patients

Despite significant research, there are still inconsistent findings regarding gender differences in cognitive performance in individuals already diagnosed with schizophrenia; studies have found that males suffering from schizophrenia are more, less or equally impaired compared with females. Gender differences in cognitive performance in individuals suffering from schizophrenia may be influenced by gender differences in premorbid cognitive performance; the very few and very small N studies published indicated that males have a poorer pre-morbid cognitive performance than females. This study examined the gender differences in premorbid cognition, utilizing cognitive assessments performed on female and male adolescents before induction into military service. The Israeli Draft Board Registry, which contains cognitive assessments equivalent to IQ scores on 16-18 year old Israeli adolescents, was linked with the Israeli National Psychiatric Hospitalization Case Registry, which records all psychiatric hospitalizations in the country. Scores on premorbid cognitive performance in schizophrenia were examined in 90 female-male case pairs matched for school attended as a proxy for socio-economic status. The mean age of first hospitalization was 20. 1+/-1.8 years of age for males and 19.6+/-1.8 years of age for females. A repeated-measures ANCOVA with age of first hospitalization and years of formal education as covariates, and controlling for gender differences in cognitive performance in healthy adolescents, revealed a significant difference in pre-morbid cognitive performance between males and females on all four cognitive measures [F(1,87)=8.07, P=0.006] with females scoring lower (worse) than males. In this national cohort, pre-morbid cognition was poorer in female, compared with male, adolescents who will suffer from schizophrenia in the future, a result consistent with some, but not all, similar studies. These results may be valid only for patients with first hospitalization around age 20. Hence, gender differences in premorbid cognition should be taken into account when assessing gender differences in cognition in schizophrenia.     

An MRI study of structural variations in schizophrenia using deformation field morphometry

Magnetic resonance imaging (MRI) has an important role in investigating the changes in brain structure that are associated with schizophrenia. In this study, MRI scans of patients diagnosed with schizophrenia (37 males; 19 females; 17-42 years of age) were compared with those of an age- and sex-matched group of normal subjects (37 males; 19 females; 18-40 years of age). Based on the images of the healthy control subjects, we constructed a representative average brain template. Automated image analysis techniques were used to measure differences in the regional nonlinear deformation fields between the two groups. A deformation field, which measures the spatial transformation to deform a template of brain anatomy to each individual data, was obtained as a three-dimensional displacement vector in each voxel. There was a significantly greater magnitude of the deformation fields in the superior frontal and parietal lobes as well as in the cingulate gyrus connecting both lobes of the patients with schizophrenia than in those of healthy controls, suggesting that these cerebral regions have a significantly higher structural variability in schizophrenia.     

Language lateralization in female patients with schizophrenia: an fMRI study

Gender differences in schizophrenia are among the most consistently reported findings in schizophrenia research. However, the biological substrate underlying these gender differences is still largely unknown. Differences in language lateralization between men and women may underlie some gender differences in schizophrenia.

In previous functional imaging studies, language lateralization was found to be decreased in male schizophrenia patients as compared to healthy males, which was due to enhanced language activation of the right hemisphere as compared to the healthy males. It could be hypothesized that decreased language lateralization in schizophrenia is gender specific, i.e. decreased lateralization in male patients and normal lateralization in female patients.

To test this hypothesis, language activation was measured in 12 right-handed female patients with schizophrenia and 12 healthy females, and compared to findings in 12 male patients and 12 male controls of an earlier study.

Language lateralization was significantly lower in the female patients (0.44) as compared to the female controls (0.75), which was due to increased activation of the right-sided language areas (patients: 19 voxels; controls: 8 voxels), while left hemisphere activation was similar in patients and controls. When these data are compared to the male patients and controls, both patient groups had lower lateralization than their healthy counterparts, but there was no difference between male and female patients. In both sexes, decreased lateralization resulted from increased right hemispheric language activation, which suggests a failure to inhibit nondominant language areas in schizophrenia. These findings indicate that lower language lateralization in women is not likely to underlie gender differences in schizophrenia.     

Gender-related differences among Turkish patients with obsessive-compulsive disorder

The purpose of the present study was to investigate gender-related sociodemographic and clinical differences among Turkish patients with obsessive-compulsive disorder (OCD). A total of 169 patients diagnosed with OCD by DSM-III-R or DSM-IV criteria were included in this study. Male (n = 73) and female (n = 96) OCD patients were compared with respect to the demographic variables and the scores obtained from the Hamilton Rating Scale for Anxiety (HRSA), the Hamilton Rating Scale for Depression (HRSD) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). We found a significantly earlier age at onset in male patients. No significant difference in terms of HARS, HDRS, and Y-BOCS scores was detected between the two groups. We observed a significantly higher frequency of contamination obsessions in females, and that of aggression and sexual obsessions in males. There was no significant difference in terms of the frequency of compulsions between the two groups. We also found that compulsion severity on obsessions/compulsions was higher in females and comorbidity rates of social phobia and schizophrenia were higher in males. Considering our results in combination with those of other studies, similarities rather than differences in gender-related sociodemographic and clinical characteristics of OCD patients across different populations seem to be present.     

Do sex differences affect prefrontal cortex associated cognition in schizophrenia?

Cognitive deficits in schizophrenia, especially those related to prefrontal cortex (PFC) functions, influence functional outcome. There is evidence for sex differences in cognition in schizophrenia, but the results in the literature are still controversial.ObjectiveThis study evaluated different modalities of working memory (WM) and executive control (EC), functions that are both associated with the PFC, between sexes in schizophrenic patients and controls.MethodsWe used a battery of neuropsychological tests for assessing auditory, spatial, and visual-matching WM and used a dual task for assessing EC. The study included 50 inpatients (25 female) partially remitted and taking atypical neuroleptics, as well as 40 controls (20 female) matched for age and education.ResultsSignificant sex differences were found in the dual task; female patients detected fewer correct trials than male patients and controls did. Moreover, female patients performed significantly worse in the single visual subtest of the dual task. For the controls, no sex differences were found. Males showed higher positive symptoms than females, but no other differences in psychopathology, disease characteristics, or extrapyramidal symptoms were found between sexes.ConclusionThe present study shows an absence of sex differences in WM in healthy subjects and in patients with schizophrenia. However, in the dual task and in the single visual subtest, female patients performed worse than males. This finding suggests that in contrast to males, nonacute female inpatients show an underlying attentional deficit that may contribute to impairment in higher-order functions such as EC.     

帕金森病初诊患者的非运动症状特点及其性别差异

目的 探讨初诊帕金森病(PD)患者非运动症状(NMS)的特点及其性别差异.方法 选取首次就诊的PD患者203例(男性102例,女性101例)及正常对照者255例(男性110例,女性145例),收集入组对象的临床资料并采用简易智能评估量表(MMSE)、蒙特利尔认知评估量表(MoCA)、汉密尔顿抑郁量表(HAMD)、汉密尔...     

The effect of gender on emotion perception in schizophrenia and bipolar disorder

OBJECTIVE: Impaired emotion perception is documented for schizophrenia, but findings have been mixed for bipolar disorder. In healthy samples females perform better than males. This study compared emotion perception in schizophrenia and bipolar disorder and investigated the effects of gender. METHOD: Visual (facial pictures) and auditory (sentences) emotional stimuli were presented for identification and discrimination in groups of participants with schizophrenia, bipolar disorder and healthy controls. RESULTS: Visual emotion perception was unimpaired in both clinical groups, but the schizophrenia sample showed reduced auditory emotion perception. Healthy males and male schizophrenia subjects performed worse than their female counterparts, whereas there were no gender differences within the bipolar group. CONCLUSION: A disease-specific auditory emotion processing deficit was confirmed in schizophrenia, especially for males. Participants with bipolar disorder performed unimpaired.     

Gender-specific associations of depression with positive and negative symptoms in acute schizophrenia

This clinical study analyzed gender-specific relationships of depression with other psychopathological and clinical variables in hospitalized patients with schizophrenia. During clinical routine treatment 119 inpatients with acute schizophrenia (DSM-IV) were investigated with the Calgary Depression Rating Scale for Schizophrenia (CDSS), the Clinical Global Impressions (CGI), and the Positive and Negative Syndrome Scale (PANSS). Depression scores of 77 male and 42 female patients (mean age 31.6+/-10.3 years) were related to background variables and to positive and negative symptom scores. Mean CDSS (5.8+/-5.6) and PANSS scores (total 76.9+/-22.1, positive symptoms 17.6+/-7.6, negative symptoms 20.5+/-7.8) were not significantly different between males and females. In females, depression was independently associated with higher negative symptom scores (P<0.01) and younger age (P<0.05) whereas in males positive symptoms (P<0.05) and short hospitalization (P<0.05) were the main factors associated with depression. The study revealed gender-specific differences in the relationship of depression with negative and positive symptoms.