Gender differences in re‐offending among psychiatrically examined Swedish offenders

Background The gender gap for violent offending is narrowing in the general population. Substance abuse and mental health problems are known risk factors for criminality. While substance abuse treatment has been associated with reduced risk of re‐offending, women seem less likely to engage than men. People misusing substances tend to be high users of emergency room (ER) services. Such use may be an indicator both of treatment failure for substance misuse and offending. Little is known about gender differences in this respect. Aims This study aims to test for gender differences in re‐offending, use of substance abuse treatment, and hospital ER visits among offenders referred for forensic psychiatric assessment in Sweden. Method The study used a longitudinal retrospective design. Data on all 31 women from a 2‐year (2000–2001) cohort of serious offenders referred for forensic psychiatric assessment in Stockholm county, and 31 men from the same cohort, were extracted from forensic service and national records. Selection of the men was by initial random sampling followed by matching on age and substance misuse. The two resulting samples were compared on health service use and re‐offending data between release and the census date (30 April 2004). Results There were no gender differences for violent re‐offending or for engagement in planned substance abuse treatment, in spite of longer time at risk for the men. Re‐offending was reduced for women but not men who did not present in the ER with physical health problems. Conclusions Our study is limited by sample size, although it included all women referred to the specialist forensic psychiatric service over 2 years, but it does indicate that differences between men and women in this situation are likely, and worthy of further study. The only way of achieving adequate sample sizes is likely to be through multi‐centre collaboration. Copyright © 2010 John Wiley & Sons, Ltd.     

Sex differences in normal age trajectories of functional brain networks

Resting‐state functional magnetic resonance image (rs‐fMRI) is increasingly used to study functional brain networks. Nevertheless, variability in these networks due to factors such as sex and aging is not fully understood. This study explored sex differences in normal age trajectories of resting‐state networks (RSNs) using a novel voxel‐wise measure of functional connectivity, the intrinsic connectivity distribution (ICD). Males and females showed differential patterns of changing connectivity in large‐scale RSNs during normal aging from early adulthood to late middle‐age. In some networks, such as the default‐mode network, males and females both showed decreases in connectivity with age, albeit at different rates. In other networks, such as the fronto‐parietal network, males and females showed divergent connectivity trajectories with age. Main effects of sex and age were found in many of the same regions showing sex‐related differences in aging. Finally, these sex differences in aging trajectories were robust to choice of preprocessing strategy, such as global signal regression. Our findings resolve some discrepancies in the literature, especially with respect to the trajectory of connectivity in the default mode, which can be explained by our observed interactions between sex and aging. Overall, results indicate that RSNs show different aging trajectories for males and females. Characterizing effects of sex and age on RSNs are critical first steps in understanding the functional organization of the human brain. Hum Brain Mapp 36:1524–1535, 2015. © 2014 Wiley Periodicals, Inc.     

Sex differences in cobalamin vitamin B12 opinions of Swedish physicians

The aim of the study was to elucidate possible sex differences in knowledge, competence and attitudes behind decision-making on cobalamin-associated problems (vitamin B(12)). The study was conducted by postal questionnaires to Swedish physicians in 1996-98. The participants were recruited by random sampling of general practitioners (1996, 1998), and a total sampling of geriatricians (1998). The overall response rate was 71%. The study group comprised 480 female physicians and 526 male physicians. The responses to 24 statements in the questionnaire were measured by means of visual analogue scales. Group differences were evaluated by medians and shapes of distributions. The female doctors appeared to value patient-related symptoms and signs more than male doctors. Conversely, male doctors relied on laboratory tests more than female doctors. As reflected by questionnaire answers, female doctors appeared to be more informed than male doctors on cobalamin-associated clinical problems. Group differences between the sexes were marginal from a numerical point of view. It is suggested that the statistical differences observed should be regarded as negligible until confirmed by further studies.     

Sex/gender differences in cognitive trajectories vary as a function of race/ethnicity

IntroductionThe present study sought to determine whether cognitive trajectories differ between men and women across and within racial/ethnic groups.MethodsParticipants were 5258 non-Hispanic White (NHW), Black, and Hispanic men and women in the Washington/Hamilton Heights-Inwood Columbia Aging Project who were administered neuropsychological tests of memory, language, and visuospatial abilities at 18- to 24-month intervals for up to 25 years. Multiple-group latent growth curve modeling examined trajectories across sex/gender by race/ethnicity.ResultsAfter adjusting for age and education, the largest baseline differences were between NHW men and Hispanic women on visuospatial and language, and between NHW women and Black men on memory. Memory and visuospatial decline was steeper for Black women compared with Hispanic men and NHW women, respectively.DiscussionThis study takes an important first step in understanding interactions between race/ethnicity and sex/gender on cognitive trajectories by demonstrating variability in sex/gender differences across race/ethnicity.     

Sex differences in neurodevelopmental trajectories in children with different levels of autistic traits

Aim

Little is known about early manifestations of autism spectrum disorders (ASD) in females, including those who may be overlooked by the current diagnostic criteria. We longitudinally explored sex differences in the trajectories of cognitive and motor functions and adaptive behaviors in children with different levels of autistic traits.

Methods

The participants were 824 children from the Hamamatsu Birth Cohort for Mothers and Children (HBC Study), Japan, who were classified into three autistic trait groups—low, moderate, and high—based on the Social Responsiveness Scale–Second Edition. Cognitive and motor functions were measured at seven time-points from 0.5 to 3.5 years of age using the Mullen Scales of Early Learning. Adaptive behaviors were measured at five time-points from 2.7 to 9 years of age using the Vineland Adaptive Behavior Scales–Second Edition. Trajectories were depicted using latent growth curve modeling.

Results

Sex-specific trajectories were observed in the high-autistic-trait group, with only males showing a temporary decline in expressive language around the age of 2 years and a slight improvement thereafter. They also showed a slight improvement around 3 years in the adaptive behavior communication domain but a gradual downward trend later. Females in the high-autistic-trait group showed no distinct manifestation before the age of 3 years but showed a downward trend after 3.5 years in the adaptive behavior communication domain.

Conclusion

Females and males with higher autistic traits than their same-sex peers, independent of clinical diagnosis, may have different phenotypes in certain neurodevelopmental domains during infancy and early childhood.     

Sex differences in cobalamin (vitamin B 12 ) opinions of Swedish physicians

The aim of the study was to elucidate possible sex differences in knowledge, competence and attitudes behind decision-making on cobalamin-associated problems (vitamin B 12 ). The study was conducted by postal questionnaires to Swedish physicians in 1996-98. The participants were recruited by random sampling of general practitioners (1996, 1998), and a total sampling of geriatricians (1998). The overall response rate was 71%. The study group comprised 480 female physicians and 526 male physicians. The responses to 24 statements in the questionnaire were measured by means of visual analogue scales. Group differences were evaluated by medians and shapes of distributions. The female doctors appeared to value patient-related symptoms and signs more than male doctors. Conversely, male doctors relied on laboratory tests more than female doctors. As reflected by questionnaire answers, female doctors appeared to be more informed than male doctors on cobalamin-associated clinical problems. Group differences between the sexes were marginal from a numerical point of view. It is suggested that the statistical differences observed should be regarded as negligible until confirmed by further studies.     

Social mobility and mental health in a Swedish cohort

Data from Project Metropolitan, a study of a Stockholm cohort born in 1953, is used to investigate the relationship between social mobility and mental health. The analysis was based on 6928 males and included data gathered on the parents of the cohort at birth and during childhood, at draft board examinations conducted at age 19 years, census records when the cohort was aged 27 years and hospital records for the period during which the cohort was aged 20–30 years. At the age of 19 years, the sons of unskilled working class parents had a prevalence of psychiatric disorder that was approximately twice that of those born into upper-middle class families and they were one-third as likely to be rated as having a high coping ability. There was a strong association between mental health and the occupational status of the cohort members themselves at the age of 27 years. The health of those not fully employed and, to a lesser extent, those classified as studients, was especially problematic. The sons of parents who exhibited downwards mobility during the childhood of the cohort had a greater risk of psychiatric disorder during early adulthood than those with parents who either rose in status or remained static. Intergenerational mobility, comparing the occupation of sons at the age of 27 years with that of their a clear gradient in mental health: sons who rose in status had high ratings for coping ability and a low risk of psychiatric disorder, those who fell in status had low ratings for coping ability and a relatively high risk of impairment. Comparisons between Project Metropolitan and the British National Child Development Study (NCDS) cohort suggest that the selective effects of health may be more important in determining intergenerational social mobility than has sometimes been claimed.     

Sex differences in schizophrenia

Evidence suggests sex differences in schizophrenia reflect differences in both neurodevelopmental processes and social effects on disease risk and course. Male:female incidence approximates 1.4:1 but at older onset women predominate. Prevalence differences appear smaller. Men have poorer premorbid adjustment and present with worse negative and less depressive symptoms than women, which may explain their worse medium term outcome according to a range of measures. Substance abuse is a predominantly male activity in this group, as elsewhere. Findings of sex differences in brain morphology are inconsistent but occur in areas that normally show sexual dimorphism, implying that the same factors are important drivers of sex differences in both normal neurodevelopmental processes and those associated with schizophrenia. There are sex differences in antipsychotic responses but sex-specific endocrine effects on illness and response to antipsychotics are potentially complex. Oestrogen's role as an adjunctive medication is not yet clear due to methodological differences between the few randomized controlled trials. Services that are sensitive to differences in gender can better meet their patients' specific needs and potentially improve outcome.     

Sex differences in schizophrenia

Demographic and clinical characteristics of 275 schizophrenics consecutively admitted to seven hospitals were examined. Males were younger than females when first hospitalized, diagnosed and treated. Psychiatrists rated on two rating scales by using a structured interview to compare the symptomatology. Female schizophrenics were more agitated, inappropriate, silly, irrelevant, over-talkative, and exhibiting more flight of ideas, while male schizophrenics were more slowed, hypoactive, grandiose, withdrawn, and showing more blocking, auditory hallucinations and poor communications. Katz Adjustment Scales were rated by the patients and their relatives. Female schizophrenics were perceived by relatives to be more helpless and withdrawn-depressed than male schizophrenics.     

Sex differences in stroke

Increasing evidence suggests that sex differences exist in the etiology, presentation, treatment, and outcome from stroke. The reasons for these sex disparities are becoming increasingly explored, but large gaps still exist in our knowledge. Experimental studies over the past several years have demonstrated intrinsic sex differences both in vivo and in animal models which may have relevance to our understanding of stroke in clinical populations. A greater understanding of the differences and similarities between males and females with respect to the risk factors, pathophysiology, and response to stroke will facilitate the design of future clinical trials and enhance the development of treatment strategies to improve stroke care in both sexes. This article reviews the current literature on sex differences in stroke with an emphasis on the clinical data, incorporating an analysis of bench research as it pertains to the bedside.     

Sex differences in autism

Comparisons were made between male and female children with autism, 384 boys and 91 girls, aged 3 years to 8 years, on nonverbal measures of intelligence, adaptive functioning, receptive vocabulary, perception, and eye-hand integration, and on ratings of affect, play, and relating and human interest. Males showed more advanced performances on eye-hand integration and perception skills on the Psychoeducational Profile (PEP) and had higher nonverbal IQs social quotients, and Peabody Picture Vocabulary Test (PPVT) IQs than females. When nonverbal IQ was controlled, the main effect of sex remained; however, sex differences on PPVT scores and on eye-hand integration and perception scale disappeared. Males showed more unusual visual responses and less appropriate, more stereotypic play than females. These results are discussed in terms of hypotheses concerning sex differences in genetic thresholds and in hemispheric lateralization.Our thanks are extended to the parents and children who participated in the initial TEACCH diagnostics, and to Robert DeVellis and Barbara Renner for help with computer programming and statistical advice.     

Sex differences in stroke

Sex differences in stroke are observed across epidemiologic studies, pathophysiology, treatments, and outcomes. These sex differences have profound implications for effective prevention and treatment and are the focus of this review. Epidemiologic studies reveal a clear age-by-sex interaction in stroke prevalence, incidence, and mortality. While premenopausal women experience fewer strokes than men of comparable age, stroke rates increase among postmenopausal women compared with age-matched men. This postmenopausal phenomenon, in combination with living longer, are reasons for women being older at stroke onset and suffering more severe strokes. Thus, a primary focus of stroke prevention has been based on sex steroid hormone-dependent mechanisms. Sex hormones affect different (patho)physiologic functions of the cerebral circulation. Clarifying the impact of sex hormones on cerebral vasculature using suitable animal models is essential to elucidate male–female differences in stroke pathophysiology and development of sex-specific treatments. Much remains to be learned about sex differences in stroke as anatomic and genetic factors may also contribute, revealing its multifactorial nature. In addition, the aftermath of stroke appears to be more adverse in women than in men, again based on older age at stroke onset, longer prehospital delays, and potentially, differences in treatment.     

Sex differences in schizophrenia

Evidence suggests sex differences in schizophrenia reflect differences in both neurodevelopmental processes and social effects on disease risk and course. Male:female incidence approximates 1.4:1 but at older onset women predominate. Prevalence differences appear smaller. Men have poorer premorbid adjustment and present with worse negative and less depressive symptoms than women, which may explain their worse medium term outcome according to a range of measures. Substance abuse is a predominantly male activity in this group, as elsewhere. Findings of sex differences in brain morphology are inconsistent but occur in areas that normally show sexual dimorphism, implying that the same factors are important drivers of sex differences in both normal neurodevelopmental processes and those associated with schizophrenia. There are sex differences in antipsychotic responses but sex-specific endocrine effects on illness and response to antipsychotics are potentially complex. Oestrogen's role as an adjunctive medication is not yet clear due to methodological differences between the few randomized controlled trials. Services that are sensitive to differences in gender can better meet their patients’ specific needs and potentially improve outcome.     

Sex differences in schizophrenia: a commentary.

A critique is offered of Samuels' article suggesting that reported sex differences in concordance rates for schizophrenia are either methodological artifacts or a function of sociological processes. Evidence of sex differences in age of onset, clinical expression, concordance rates among primary relatives, and premorbid competence is cited. Finally, it is concluded that sex differences in schizophrenia offer important clues to the development of the disorder and should be considered in future theories of schizophrenia.     

Early risk factors for criminal offending in schizophrenia: a 35-year longitudinal cohort study

Background  

Recent evidence suggests that factors predicting offending among individuals with no mental disorder may also predict offending among individuals with schizophrenia.