生活事件影响健康人和精神分裂症病人的性别差异

目的　比较生活事件影响健康人和精神分裂症病人的性别差异。方法　采用修订的生活事件量表 (草案 )分别对男女健康人和精神分裂症病人进行测试 ,并比较两性在一般项目、量表总分及因子分的差异。结果　总分比较表明 ,精神分裂症组和健康人组女性得分均明显高于男性 ,且差异显著 ;因子分比较则分别显示 ,精神分裂症组在有关女子问题 ,健康人组在有关经济、家庭、灾难等项目 ,女性得分高于男性 ,且有显著性差异。结论　生活事件对健康人和精神分裂症病人的影响存在着性别差异     

Leukocyte telomere length: Effects of schizophrenia,age, and gender

BackgroundSchizophrenia is linked with early medical comorbidity and mortality. These observations indicate possible “accelerated biological aging” in schizophrenia, although prior findings are mixed, and few such studies have examined the role of gender. One putative marker of biological aging is leukocyte telomere length (LTL), which typically shortens with age.MethodsWe assessed LTL in phenotypically well characterized 134 individuals with schizophrenia (60 women and 74 men) and 123 healthy comparison subjects (HCs) (66 women and 57 men), aged 26 to 65 years.ResultsOverall, LTL was inversely associated with age (t(249) = -6.2, p < 0.001), and a gender effect on the rate of LTL decrease with age was found (t(249) = 2.20, p = 0.029), with men declining more rapidly than women. No significant overall effect of diagnosis on the rate of decline was detected. However, at the average sample age (48 years), there was a significant gender effect in both schizophrenia and HC groups (t(249) = 2.48, p = 0.014), with women having longer LTL than men, and a significant gender X diagnosis effect (t(249) = 2.43, p = 0.016) - at the average sample age, women with schizophrenia had shorter LTL than HC women.DiscussionGender, not the diagnosis of schizophrenia, was the major factor involved with LTL shortening across the age range studied. We discuss the constraints of a cross-sectional design and other methodological issues, and indicate future directions. Understanding the impact of schizophrenia on biological aging will require separate evaluations in men and women.     

Peculiar word use as a possible trait marker in schizophrenia

Peculiar word use in schizophrenia has been emphasized by many authors, however the definition or the linguistic and clinical correlates of this phenomenon are not clear. We propose a new, standard and reliable method to extract a numerical measure of peculiar word use with operationalized definitions. We applied a modified version of the Controlled Word Association Test (Turkish version) to a pool of healthy subjects (N=55) and used the data as norm to compare the degree of peculiarity and patterns of word association among patients with schizophrenia (N=33), their healthy siblings (N=31) and healthy controls (N=32). We also explored the relationship of peculiar word use with patterns of word association (semantic versus phonologic) and formal thought disorder. Patients and their siblings performed worse on measures of verbal fluency. They also generated more peculiar words and relied less on semantic associations, compared to healthy controls. Peculiar word use was associated with the severity of formal thought disorder and the tendency to make use of phonologic associations in the patient group and their siblings, whereas neither of the word association patterns predicted peculiar word use in the control group. Our results provide empirical support to previous observations about the peculiarity of schizophrenic speech. Peculiar word use could be associated with a deficit to employ semantic classifications in verbal fluency tasks and thus relying more on sound-based associations. Excess use of phonologic associations may be playing a mediating role between semantic processing abnormalities and formal thought disorder.     

不同年龄的男性精神分裂症患者血清中睾酮浓度比较结果

目的：探讨不同年龄的男性精神分裂症患者血清中睾酮浓度的差异。方法：将175例男性精神分裂症患者按年龄分为老,中,青三个组,测定其血清总睾酮水平和性激素结合球蛋白浓度,计算出血清游离睾酮水平,然后与190例正常受试者进行比较。结果：与对照组相比,男性精神分裂症患者青年组血清睾酮水平无差异（P＞0．05）,而中,老年组血清睾酮水平则显著降低（P＜0．05,P＜0．01）。研究组血清睾酮水平均随年龄升高而下降,并较对照组显著（P＜0．01）,结论：不同年龄的男性精神分裂症患者血清中睾酮水平低于同龄的正常男性。     

保定市精神分裂症性别差异的流行病学调查

目的了解保定市精神分裂症的患病率及其性别分布特点。方法2004年10月~2005年3月采用多阶段分层整群抽样方法随机抽取≥18岁的人群,共10073例,用扩展的一般健康问卷（GHQ-12）将调查对象分为高、中、低危险组,采用美国精神障碍诊断标准（DSM-Ⅳ）,以美国精神障碍诊断与统计手册第4版（DSM-Ⅳ）轴Ⅰ障碍定式临床检查患者版对调查对象进行精神分裂症的诊断。功能状况评价采用大体功能评定量表（Global Assessment Function,GAF）。结果9021人完成调查,精神分裂症的终生及时点患病率分别为6.20‰、5.42‰,男性3.93‰、3.28‰,女性8.45‰、7.55‰,女性均高于男性（P〈0.01）;女性已婚率显著高于男性（P〈0.01）,而受教育年数女性显著低于男性（P〈0.01）;精神分裂症的临床症状、发病年龄与诊断分型性别比较无显著性差异;女性心理、社会及职业功能受损程度较男性为重（P〈0.05）。精神卫生服务利用的性别间均无显著性差异。结论精神分裂症患者在患病率、婚姻、教育及心理、社会、职业功能均存在性别差异,提示在制定治疗康复方案时,应有所区别。     

家族史和性别对精神分裂症精神病理学结构的影响

为了解家族史和性别对精神分裂症精神病理学构成的影响及联合效应，对符合中国精神疾病分类方案与诊断标准第２版精神分裂症诊断标准的１９４例病人进行简明精神病评定量表评定，并依性别和家族史分组。结果显示，单因素分析时，家族性精神分裂症阴性症状构成显著高于散发性精神分裂症，而阳性症状构成显著低于散发性精神分裂症；同时还发现，男性精神分裂症非特异性症状构成显著高于女性精神分裂症。双因素分析时，男性家族性精神分裂症阳性症状构成显著低于女性散发性精神分裂症，散发组男性非特异症状构成显著高于女性，提示性别、家族史对精神分裂症某些精神病理现象有影响，且有联合效应。     

儿童焦虑症状与性别、年龄的关系

目的 探讨儿童焦虑症状随性别、年龄的变化趋势及焦虑症状与性别、年龄之间的关系.方法 在小学和初中随机抽取4 200名7～15岁的儿童,进行儿童焦虑障碍自评量表（SCARED）的测量,并按年龄分组,分析性别和年龄与自评量表得分之间的关系.结果 各焦虑维度评分及焦虑总分在性别与年龄之间均有交互作用（P＜0.05）;男、女儿童不同年龄组的各焦虑维度评分及焦虑总分差异均有统计学意义（P＜0.01）;10～11岁年龄组分离性维度（t=-2.591,P=0.010）、社交维度（t=-3.573,P=0.00）、焦虑总分（t=-2.288,P=0.022）,以及14 ～ 15岁年龄组躯体化维度（t=-2.349,P=0.019）、广泛性维度（t=-4.65,P=0.00）、分离性维度（t=-4.513,P=0.00）、社交维度（t=-5.25,P=0.00）、学校维度（t=-2.073,P=0.039）、焦虑总分（t=-5.057,P=0.00）均女生高于男生.结论 性别、年龄对儿童焦虑症状的交互作用明显;男、女儿童焦虑症状均随年龄发生变化,但呈现不同变化趋势,随年龄增长男生的焦虑症状减轻而女生的焦虑症状增多;女生焦虑症状明显于男生,尤其在14～15年龄段.     

年龄、性别和父母教养方式对小学生自我概念发展的影响

目的探讨年龄、性别和父母教养方式对小学生自我概念发展的影响。方法使用Piers—Harris儿童自我概念量表、父母养育方式问卷（EMBU）以及结合小学生不同年龄、性别的特征对其自我概念的发展的影响进行了探讨。结果表明小学生自我概念部分分量表得分及总分与性别和年龄差异均显著;父母的情感温暖和理解与小学生自我概念的发展呈显著的正相关,而母亲的拒绝否认与小学生自我概念的发展呈显著的负相关。结论女生比男生有更好的学校表现和躯体外貌的评价、更为合群、行为问题更少和更为自信;在不同的年龄组间自我概念呈现不同的发展水平;父母教养方式是影响小学生自我概念发展的一个重要因素之一。     

Effects of age and gender on single-dose pharmacokinetics of gabapentin

PURPOSE: This study was conducted to evaluate the effect of age, age-related changes in renal function, and gender on the single-dose pharmacokinetics of orally administered gabapentin (GBP). METHODS: The pharmacokinetics of a single 400-mg oral dose of GBP were studied in 36 healthy subjects (18 men and 18 women) aged 20-78 years. Serial blood samples and total urine output were collected for 48 h after the dose. GBP concentrations in plasma and urine were measured by high-performance liquid chromatography, and pharmacokinetic parameters were calculated by noncompartmental methods. RESULTS: All subjects tolerated the drug well, with only mild symptoms reported. No change in maximal GBP plasma concentration (Cmax), time at which Cmax occurred (tmax), or apparent volume of distribution (V/F) with age was noted. A significant linear decline in apparent oral clearance (CL/F), elimination-rate constant (lambda z), and renal clearance (CLR) with increasing age was observed (p < 0.005). Because total urinary recovery of unchanged drug (an estimate of F for GBP) did not change with age, the decline in CL/F and lambda z can be explained by the decline in CLR. The only pharmacokinetic parameter that was significantly different between genders was Cmax, which was approximately 25% higher for women than for men (p = 0.016), consistent with gender differences in body size. CONCLUSIONS: The results of this study suggest that changes in renal function are responsible for age-related changes in GBP pharmacokinetics. Reduction of GBP dosage may be required in elderly patients with reduced renal function. The pharmacokinetics of GBP are similar in men and women.     

Activated protein C resistance: the influence of ABO-blood group, gender and age

We have evaluated the potential influence of ABO-blood group, gender and age, on laboratory procedures used for detection of Activated Protein C Resistance (APCR), using over 300 normal donor samples and two distinct laboratory test procedures, one based on an Activated Partial Thromboplastin Time (APTT) and the other on a Russell Viper Venom Time (RVVT). We observed a statistically significant influence of ABO-blood group on APTT test times, both in the presence and absence of Activated Protein C (APC), which was no longer evident when using assay ratios. This ABO effect was not observed using the RVVT-based assay procedure. We also observed a gender effect on the APTT-based procedure, such that females (compared to males) provided shorter APTT test times (both with and without APC). This effect was still evident when using APTT assay ratios, but was again not observed using the RVVT-based procedure. We also observed an age related increase in APTT ratios. Interestingly, some previous studies have reported some specific gender and age related effects on APTT-based testing, but reports using RVVT-based testing are lacking, as are ABO related studies. Such findings should be considered as potential variables when associating specific laboratory based findings of APCR to clinical thrombophilia conditions.     

Sex/gender differences in the brain and cognition in schizophrenia

The early conceptualizations of schizophrenia have noted some sex/gender differences in epidemiology and clinical expression of the disorder. Over the past few decades, the interest in differences between male and female patients has expanded to encompass brain morphology and neurocognitive function. Despite some variability and methodological shortcomings, a few patterns emerge from the available literature. Most studies of gross neuroanatomy show more enlarged ventricles and smaller frontal lobes in men than in women with schizophrenia; finding reflecting normal sexual dimorphism. In comparison, studies of brain asymmetry and specific corticolimbic structures, suggest a disturbance in normal sexual dimorphism. The neurocognitive findings are somewhat consistent with this picture. Studies of cognitive functions mediated by the lateral frontal network tend to show sex differences in patients which are in the same direction as those observed in the general population, whereas studies of processes mediated by the corticolimbic system more frequently reveal reversal of normal sexual dimorphisms. These trends are faint and future research would need to delineate neurocognitive differences between men and women with various subtypes of schizophrenia (e.g., early versus late onset), while taking into consideration hormonal status and gender of tested participants.     

Admixture analysis of age at onset in schizophrenia: evidence of three subgroups in a first-episode sample

Objective

The objective was to assess the presence of different subgroups, via age-at-onset (AAO) analysis, in a schizophrenia population consecutively recruited through an Early Psychosis Service in London, Canada.

Method

Admixture analysis was applied in order to identify a model of separate normal distribution of AAO characterized by different means, variances and population proportions to allow for evaluation of different subgroups in a sample of 187 unrelated patients with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of schizophrenia.

Results

The best-fitting model suggested three subgroups with means and standard deviations of 16.8±1.9, 22.3±2.1 and 32.7±5.9 years comprising 41%, 30% and 29% of the schizophrenia sample, respectively. These three subgroups were categorized as early, intermediate and late onset with cutoffs determined by admixture analysis to be 19 and 26 years of age, respectively. In our investigation, the definition of early-onset schizophrenia is the main outcome. We considered the clinical variables mainly related to the heritability and neurobiology of schizophrenia. Single status was strongly associated with early onset (P< .001). The male gender (P= .023), as well as a history of drug abuse (P= .004), was significantly associated with early onset. Interestingly, lower academic achievement was also associated with early-onset schizophrenia (P< .001).

Conclusion

Overall, our study showed that a typical early-onset schizophrenia patient is more likely to be a single male, with a history of drug abuse and birth complications, and lower academic achievement as compared to the late-onset subgroup.     

The effects of age, gender, and body mass index on amplitude of sensory nerve action potentials: Multivariate analyses

ObjectivePrevious studies have shown that age, gender, and body mass index (BMI) affect amplitude of sensory nerve action potentials (SNAP), but the total effects of multiple factors or the most prominently affected nerves have not been elucidated. This study systematically investigated effects of these factors.MethodsAmplitude of SNAP of the median, ulnar, superficial radial, superficial peroneal, and sural nerves was measured in 105 healthy subjects. The effects of age, gender, and BMI on each nerve were estimated by multivariate linear regression analysis.ResultsSNAP amplitude decreased with age in all five nerves. Women had greater SNAP amplitude than men in the upper limb nerves (median, ulnar, and radial), but not in the lower limb nerves (peroneal and sural). Similarly, greater BMI was associated with smaller amplitudes in the upper limb nerves, but not in the lower limb nerves. Multivariate analyses showed the three factors explained 50% of the variation in the median nerve, 46% in the ulnar nerve, and 22–32% in the remaining nerves.ConclusionsThe effects of age, gender, and BMI on SNAP amplitudes are not identical in different sensory nerves. Age was strongly correlated with SNAP amplitude in the nerves tested, whereas gender and BMI affect amplitudes only in the upper limb nerves.SignificanceAge, gender, and BMI should be taken into account in clinical practice, but the extent of influence depends on the sensory nerves examined.     

Socio-demographic and clinical predictors of quality of life in patients with schizophrenia or schizo-affective disorder

This article discusses the relationships between socio-demographic, clinical characteristics and Quality of Life (QOL) of individuals with schizophrenia. The client version of the Canadian version of the Wisconsin Quality of Life Index (CaW-QLI) was used with a population of 182 individuals with either schizophrenia or schizo-affective disorder. Multivariate analyses of variance with Tukey post hoc tests were used to assess differences between groups defined according to socio-demographic and clinical characteristics on all sub-scale scores in addition to the global score on the CaW-QLI. Relationships between socio-demographic characteristics and QOL were found for gender, age, education, employment status and living arrangement. Differences in QOL were found between groups with different clinical characteristics, such as diagnosis, hospitalization during the last 12 months and age at first hospitalization. Using socio-demographic and clinical variables in addition to psychosocial variables appears to be promising for understanding QOL in psychotic patients. Methodological considerations for future research are discussed.     

Asymmetry of the ventricle and age at the onset of schizophrenia

The relationship between lateral ventricular size or its asymmetry and age at the onset of schizophrenia was investigated in 20 schizophrenic patients diagnosed according to DSM-III-R criteria. The ventriclebrain ratio (VBR) was determined using three transaxial slices of magnetic resonance image (MRI) and asymmetry of the lateral ventricle was evaluated from the laterality index of the lateral ventricular area: (left-right/lef+right)×100. Each age at the onset of the prodromal and active phase according to DSM-III-R criteria was determined for each patient. The results showed that asymmetry of the ventricle, but not VBR, was significantly correlated inversely with age at the onset of both the prodromal phase and active phase. Neither asymmetry nor VBR correlated with the duration of illness, age at MRI scanning, or severity of clinical symptoms. It would thus appear that greater asymmetry of the ventricle is associated with earlier onset of schizophrenia.     

256层螺旋CT对颈动脉狭窄程度与性别及年龄关系的初步研究

目的采用256 i CT血管造影对颈动脉狭窄定量分析,探讨颈动脉狭窄程度与性别及年龄的关系。方法分析于本院接受256 i CT颈动脉造影检查患者的影像资料573例,男性332例,女性241例,平均年龄57.22±13.02岁。采用多平面重建(MPR)、最大密度图像(MIP)、容积再现(VR)等技术分别测量及统计颈总动脉、颈内动脉动脉粥样硬化斑块部位及狭窄程度。结果颈总动脉轻度狭窄有性别分布差异,男性轻度狭窄者较女性多(P=0.027);颈内动脉轻度狭窄无性别分布差异;颈总动脉及颈内动脉中度及以上狭窄均有性别分布差异(P=0.013,P=0.000),男性中度以上狭窄者较女性多;颈总动脉及颈内动脉动脉狭窄程度与年龄均有相关性(P=0.000),随年龄增加狭窄程度增高。结论 256 i CT颈动脉成像可以客观显示颈动脉狭窄程度及斑块部位,性别与年龄是颈动脉狭窄的重要影响因素。     

Influence of age, gender and severity of tremor on outcome after thalamic and subthalamic DBS for essential tremor

Deep brain stimulation (DBS) is an established treatment for essential tremor (ET). The nucleus ventralis intermedius thalami (Vim) is the target of choice, but promising results have been presented regarding DBS in the posterior subthalamic area (PSA). The aim of this study was to evaluate the possible influence of gender, age and severity of disease on the outcome of these procedures.Sixty eight patients (34 Vim, 34 PSA) with ET were included in this non-randomised study. Evaluation using the Essential Tremor Rating Scale (ETRS) was performed before, and one year after surgery concerning PSA DBS, and at a mean of 28 ± 24 months concerning Vim DBS. Items 5/6 and 11–14 (hand tremor and hand function) were selected for analysis of tremor outcome.The efficacy of DBS on essential tremor was not related to age or gender. Nor was it associated with the severity of tremor when the percentual reduction of tremor on stimulation was taken into account. However, patients with a more severe tremor at baseline had a higher degree of residual tremor on stimulation. Tremor in the treated hand and hand function were improved with 70% in the Vim group and 89% in the PSA group.     

Age, sex and first treatment of schizophrenia in a population cohort

Objective

Schizophrenia affects men more than women, but this may not be true at all ages. This study examines the incidence of first hospitalization for treatment of schizophrenia in each sex over different ages.

Methods

We compared the incidence of first admission for treatment in a cohort of 46,388 males and 43,680 females followed from birth until ages 29-41, using life tables and proportional hazards methods.

Results

Life table estimates of cumulative incidence by age 40 were 1.44% in males and 0.86% in females. For over all ages the relative risk (RR) in males was 1.6 (95% confidence limits = 1.4-1.8) compared with females. Before age 17 there was no significant difference between the sexes (RR = 0.86, 0.56-1.3). Excess risk in males was observed only from age 17 (RR = 1.7, 1.4-1.9). There was no evidence of the incidence in females catching up with that in males, during the 30s.

Conclusion

In this population, there was a significant change, over age, in the relative incidence of first hospitalization for schizophrenia between the sexes; the excess incidence in males first developed at age 17.     

Asymmetries of the central sulcus in young adults: Effects of gender,age and sulcal pattern

In this study, we clarified the gender and age-related asymmetries of the central sulcus (CS) in early adulthood using a parametric ribbon method. The CS was reconstructed and parameterized automatically from 3D MR images of 112 healthy right-handed subjects. The 3D anatomic morphology of the CS was presented using 5 sulcal parameters, including sulcal depth position-based profile (DPP), average depth (AD), average width (AW), top length (TL) and bottom length (BL). Asymmetry differences in DPPs were found in the medial and lateral part of the CS. In addition, significant gender differences were observed in the medial and middle parts of the right CS DPPs but scattered in the left side. We found leftward asymmetries of TL in males, but rightward asymmetries of AW in females. Males had a greater AW than females in the right hemisphere. Moreover, the females had bilateral longer TL and a longer left BL than did males. We also found significant age-related reductions in bilateral TL and increases in bilateral AW, with males presenting more obvious age-related change than females. There were sexual differences of the CS patterns, in which Type b was the most dominant sulcal pattern in males, whereas Type a was dominant in females. Three-way ANOVA revealed sexual and asymmetry changes of TL and BL among different CS patterns. Our findings indicate that the lateralization performances of the CS manifest as sexually and regionally different. In addition, it is suggested that males may undergo a faster progress of aging compared to females.