Gender differences in self-evaluated sleep quality and activity of middle-aged and aged subjects

Abstract In order to investigate the gender difference of sleep and activity in middle-aged and aged individuals, home-based sleep was self-evaluated for sleep quality and activity for 5 nights in 20 healthy adults (50–76 years old; 11 women, nine men). There was no significant gender difference for subjective sleep quality. However, the activity level and movement index at night were significantly higher in men than in women, and the activity level during the day was significantly lower in men than in women. The objective sleep quality of men was significantly worse than that of women, however, subjective sleep quality does not differ.     

精神分裂症的性别差异

目的:探讨精神分裂症患者的性别差异。方法:收集240例不同性别精神分裂症患者的首次发病年龄、病程、阳性家族史、临床症状、病前人格和诊断分型等资料,并进行分析比较。结果:首次发病年龄、病程和阳性家族史无性别差异,读心症、钟情妄想、其他妄想、思维逻辑性障碍和怪异行为等阳性症状在男性患者组和女性患者组中的分布差异有显著性,其他阳性症状及阴性症状在两组中的分布差异无显著性。结论:精神分裂症患者的阳性症状存在性别差异,女性精神分裂症患者的临床症状多表现为阳性症状。     

Gender differences in challenging behaviors, management and outcomes in elderly patients with delirium

BACKGROUND: Gender differences have been reported in some common mental disorders. However, few studies have monitored gender differences in individuals with delirium. OBJECTIVE: To explore gender differences in challenging behaviors, management and outcomes in age-matched elderly patients with delirium.DESIGN, TIME AND SETTING: A retrospective cohort study was performed in the Bankstown-Lidcombe Hospital, Sydney, Australia, from October 2008 to April 2009. METHODS: Patients, aged 65-90 years, diagnosed with delirium according to the International Classification of Diseases (ICD)-10 in the Psychogeriatric Unit of Bankstown Lidcombe Hospital from January 2002 to October 2008 were reviewed. All the patients were measured according to the Confusion Assessment Method upon admission. Those who developed delirium during hospitalization were excluded.MAIN OUTCOME MEASURES: Cause of delirium, wandering, aggression, duration of delirium, physical restraint, use of antipsychotic medicine, recovery from delirium, discharge back home, length of stay, one-to-one nursing care, falls and absconding rate.RESULTS: The 131 age-matched delirious patients comprised 54 males and 77 females. The behavioral disorders of wandering [odds ration (OR) = 2.612, 95% confidence interval (CI) = 1.26 -5.413, P = 0.009] and aggression (OR = 2.243, 95% CI = 1.028 - 4.891, P= 0.04) were more frequent in males than in females. More males received one-to-one nursing care (OR = 4.114, 95% CI = 1.355 - 12.491, P = 0.008), were more likely to receive antipsychotic medications (OR = 2.24, 95% CI = 1.095-4.583, P = 0.021) and more likely to be physically restrained (OR = 2.07, 95% CI = 1.02-1.02, P = 0.043) compared with female patients. All absconding patients (3/131, 2.3%) were male. In addition, male patients displayed a greater falling rate compared with females (OR = 4.57, 95% CI= 1.519-13.722, P = 0.004).CONCLUSION: There are gender differences in challenging behaviors, management and outcomes in elderly delirious patients. Males with delirium display more challenging behaviors that require physical restraint and pharmacological management including wandering and aggression; males also abscond and have a higher rate of falls compared with female patients.     

Gender difference of slow wave sleep in middle aged and elderly subjects

Sleep EEG of eight healthy males and eight females aged 54-72 years were recorded at their homes. The electroencephalograms were visually scored and analyzed by spectral analysis using the FFT method. There were no significant differences in sleep parameters except for a higher percentage of stage 3+4 in females. The spectral power of the delta band EEG was classified into two frequencies: 0.5-2 Hz and 2-4 Hz. The total amount of the delta band spectral power through the night was significantly larger in females. Periodic fluctuation of delta band power was observed in females along with non-rapid eye movement-rapid eye movement cycles.     

Gender differences in the trajectory classes of depressive symptoms in Korean older adults

ABSTRACT

Objectives: This study aimed (1) to identify gender-specific heterogeneous longitudinal patterns of depressive symptoms, (2) to explore the effects of economic status and various health conditions as risk factors in depressive symptom trajectories.

Method: Data came from the Korean Longitudinal Study of Aging (2006–2012) focuing on older adults aged 65 and older. Latent class growth analysis was used to identify the depressive symptom trajectory groups. Multinomial logistic regression was used to examine the association between economic and health status changes and the depresison trajectories.

Results: Among older women, three change groups were identified: stable low, stable high, and moderate but slightly increasing groups. Among older men, four groups were found: stable low, moderate but rapidly increasing, high but decreasing, and moderate but slightly increasing groups. Among women, poverty experience and sustained poor health, particularly constantly low cognition, were significantly associated with the stable high group. Among men, deteriorating economic and health status were significant predictors of membership in the most vulnerable subgroup, the moderate but rapidly increasing group.

Conclusion: This study demonstrated among older adults, depressive symptoms change heterogeneously by gender. Identification of the most at risk subgroups among older men and women provides important initial empirical information to target clinical programs and policy development.     

Gender differences in a clinic-referred sample of Taiwanese attention-deficit/hyperactivity disorder children

The purpose of this study was to examine gender differences within a clinic-referred sample of 6-11-year-old Taiwanese children with attention-deficit/hyperactivity disorder (ADHD)- combined subtype. The subjects were 21 girls with a diagnosis of ADHD from the 4th edition of the Diagnostic and Statistical Manual and 21 age-matched boys with ADHD. Comparisons were made of behavioral ratings, cognitive profiles, and vigilance/attention assessments between these two groups. The results found ADHD girls and ADHD boys to be statistically indistinguishable on nearly all measures except the subtests of block design (P = 0.016), the discrepancy between Performance Intelligence Quotient and Verbal Intelligence Quotient (P = 0.019), and the discrepancy between fluid and crystallized IQ (P = 0.041). In the study samples, ADHD girls and ADHD boys were strikingly similar on a wide range of measures. ADHD boys and girls in clinics may be expected to show more similarities than differences in treatment needs. However, these results should be interpreted with caution since data were only from clinic-referred samples.     

Gender differences in the incidence of definite schizophrenia and atypical psychosis--focus on negative symptoms of schizophrenia.

In a catchment area study of 101 first inceptions of schizophrenia, mania and atypical psychoses, women were significantly more likely to have atypical psychosis and men were more likely to have definite schizophrenia. Negative symptoms such as affective flattening and poverty of speech were already present in many cases, and were significantly increased in patients with definite schizophrenia (geometric mean 5.6) compared with those with atypical psychosis (geometric mean 3.2) and mania (geometric mean 1.5). Negative symptoms were also twice as severe in men (geometric mean 5.5) than women (geometric mean 2.6). There was a significant increase in negative symptom severity with longer illness and greater depression, but the diagnosis and the sex effects were not caused by these factors. We suggest that our findings are further support for the hypothesis that men have a greater biological vulnerability to negative symptoms and consequent social disability in the face of psychosis, particularly a schizophrenic psychosis, and that this may be one explanation for the apparently greater risk of definite schizophrenia and its poorer prognosis in men.     

Gender differences of depressive symptoms in depressed and nondepressed elderly persons.

OBJECTIVES: Women suffer more frequently from major depression and depressive symptoms than men. The somatic and the atypical subtype of depression seem to be more prevalent in women. However, few studies investigated gender differences of depressive symptoms in the elderly. These gender differences in the elderly will be investigated in the present study. METHODS: In the course of a family study 236 subjects with a lifetime diagnosis of major depression aged > 50 years and 357 control subjects from the general population matched for age and gender were questioned using the Composite International Diagnostic Interview (CIDI). Chi-square tests were used to compare the individual depressive symptoms between men and women and logistic regression analyses were performed to account for the subjects' age, cognitive performance, family and employment status. RESULTS: Women in the general population suffered from more depressive symptoms than men and had more appetite disturbance and joylessness. These gender differences could be entirely explained by gender differences in the family and the employment status. Men and women with a major depressive disorder presented with a distinct profile of symptoms that could not be explained by psychosocial factors: elderly depressed women presented with more appetite disturbances and elderly depressed men with more agitation. CONCLUSION: Major depression in the elderly presents with partially different symptoms in men and women. The results suggest that the gender differences in the symptoms of major depression in the elderly reflect gender differences in the perception and the expression of depressive syndromes.     

Predictors of outcomes from a ward for demented elderly: gender differences

Background:  In a previous study, we found gender differences among care recipients and suggested that elderly women living alone have difficulty receiving care from their families. We investigated the gender differences among predictors which influenced outcomes after discharge from a ward for treatment of demented elderly with severe psychotic symptoms.
Methods:  We enrolled the data of 325 patients with dementia who were hospitalized between 1 April 2000 and 31 March 2007, and discharged by 31 March 2008. Two hundred and ninety-four patients were divided into men and women. We checked the gender differences of their characteristics. After that, they were subdivided into three groups to analyze the effect of each patient's characteristics and care situation on their outcomes: (i) given home care (home); (ii) became institutionalized (institution); and (iii) transferred to another hospital (hospital).
Results:  In the hospital groups, the incidence of complications was high for each sex. The differences between the institution group and home group were shown by N-ADL score in men. In contrast, the predictors in women were the HDS-R score, the number of cohabitants and the caregiver.
Conclusions:  It was observed that there were gender differences among outcome predictors. The outcomes of demented patients were predicted by both complications and condition on admission. Most women did not return to their homes because of the situation in which they received care. It is necessary to establish a clear system for providing care for the demented elderly, especially for women.     

Gender differences in the contributions of risk factors to depressive symptoms among the elderly persons dwelling in a community, Japan

OBJECTIVE: To examine the relative importance of risk factors associated with depressive symptoms and gender differences in exposure to the risk factors among the elderly persons living in the community. METHODS: The data came from the Minamifurano-town Aging Study, a community-based sample of non-institutionalized elderly persons aged 65 years or older. Of the 731 eligible subjects, 665 were assessed for four domains of the potential risk factors (demographic characteristics, health and disability, stress, and social networks) and depressive symptoms according to the 30-item Geriatric Depression Scale (GDS). RESULTS: The mean overall GDS-score was 10.9 (SD 6.2), 10.2 (SD 6.0) in men and 11.6 (SD 6.4) in women. The stress domain in men and the health and disability domain in women contributed most to the explanation of the variation in the GDS-score. CONCLUSION: 'Stress' for men and 'health and disability status' for women were important factors associated with depressive symptoms. Future studies should determine whether modification of these factors may prevent depression among the elderly persons living in the community.     

Predictors of length of stay in a ward for demented elderly: gender differences

Background: In our previous studies, we found both gender differences among care recipients and predictors that influenced outcomes after discharge from a ward for demented elderly. Here, we investigate predictors that influence the length of stay for each sex. Methods: We studied the data of 390 patients with dementia who were hospitalized in a ward for demented elderly between 1 April 2000 and 31 March 2008, and treated until 31 March 2009. The patients were divided into groups classified by gender. We analyzed the gender differences of characteristics and evaluated the predictors that influenced the length of stay in the ward for demented elderly using Cox's proportional hazards model. A model using the initial scores of the Revised Hasegawa Dementia Scale (HDS‐R), Assessment Scale for Symptoms of Dementia (ASSD) and Nishimura's activity of daily living scale (N‐ADL), which were examined on admission, was named Model 1. In Model 1, we checked the effect of each patient's characteristics, except for complications and destinations, on their length of stay. Model 2 used the final scores of HDS‐R, ASSD and N‐ADL including complications and destinations. Results: There was a clear gender difference in the length of stay. The length of stay of women was longer than that of men. It was difficult to predict the length of stay in Model 1. Age was the only predictor in women and no predictor was identified in men. In Model 2, complications and the final HDS‐R and N‐ADL scores were predictors of the length of stay in men. Age, complications and destinations were predictors of the length of stay in women. Conclusions: It was observed that there were gender differences among predictors of the length of stay. However, it was difficult to predict the length of stay on admission. Retrospectively, the length of stay was determined by physical and psychological conditions, not by the social variables in men. In women, it was supposed that the caregiver's wish to give care at home reduced the length of stay. Besides, complication was a common predictor of the extension of stay in each sex. We have to decrease the number of complications as much as possible to reduce the length of stay.     

Gender and age differences in normal adult human brain: Voxel‐based morphometric study

The aim of this study was to evaluate the gender and age differences in the normal adult human brain, using voxel‐based morphometry. In this study, 227 right‐handed normal adults (male:female = 111:116) were examined. Three‐dimensional magnetic resonance brain images of each subject were segmented into gray and white matter using statistical parametric mappings. All individual data were transformed to standard brain space and then divided into older and younger age groups before examining the effects of age and gender. There was a significant negative correlation between gray matter concentration and age in each gender group. The differences were more prominent in the older age groups compared with the younger age groups. Gray matter concentrations in the bilateral inferior frontal lobes, anterior cingulate gyrus, medial thalamus, and hypothalamus were more retained in females as they aged, whereas those in the occipital regions were more retained in aging males. Our findings are consistent with biologically and hormonally established gender differences. Hum Brain Mapp, 2011. © 2010 Wiley‐Liss, Inc.     

Gender differences in epilepsy

PURPOSE: The aim of this study was to look at gender differences in unselected populations of patients with epilepsy classified according to the 1989 International League Against Epilepsy (ILAE) criteria. METHODS: Data were obtained from two sources: (a) the EpiBase database at the outpatient clinic at the Department of Neurology, Aarhus University Hospital, Denmark, confined to adults with epilepsy (n=2,170), and (b) the Danish Twin Registry (n=318). RESULTS: In localization-related epilepsy, no overall gender difference was found in either the EpiBase population (n=1,511; w=750 (50%), m=761 (50%); p=0.80) or in the twin population (n=172; w=86 (50%), m=86 (50%); p=1.00). However, in the EpiBase population, localization-related symptomatic epilepsies were more frequent in men (n=939; w=426 (45%), m=513 (55%); p=0.005); and cryptogenic localization-related epilepsies were more frequent in women (n=572; w=324 (57%), m=248 (43%); p=0.002). In generalized epilepsy, more women than men were diagnosed in both populations [EpiBase: n=480, w=280 (58%), m=200 (42%); p<0.001; twin population: n=105, w=63 (60%), m=42 (40%); p=0.05]. The difference was confined to idiopathic generalized epilepsy [EpiBase: n=437, w=259 (59%), m=178 (41%); p<0.001; twin population: n=94, w=60 (64%), m=34 (36%); p=0.01]. CONCLUSIONS: More women than men were diagnosed with idiopathic generalized epilepsy in two epilepsy populations. Overall, no gender difference was found in localization-related epilepsy, but localization-related symptomatic epilepsies were more frequent in men, and cryptogenic localization-related epilepsies were more frequent in women The results suggest a gender susceptibility to the development of specific epilepsy subtypes.     

Gender differences in brain reserve

Background Neuropathological studies suggest that the association between neurodegenerative brain damage and clinical symptoms may be stronger in women than in men. Objective To test the hypothesis that cerebral metabolic deficits due to neurodegeneration are more pronounced in men than in women at the same level of clinical disease severity. Methods 93 patients with mild Alzheimer's disease (AD; 50 men, 43 women) underwent an extensive clinical and neuropsychological examination and ¹⁸F-FDG PET imaging at a university-based outpatient unit for cognitive disorders. An analysis of covariance (with age, total score of the CERAD neuropsychological battery, and years of school education as covariates) was conducted in each study group to identify gender differences in glucose metabolism. Results Controlling for age, education, and clinical severity, cortical regions were identified,where glucose metabolism was significantly reduced in men as compared with women. These regions were located in areas typically affected by AD pathology (right inferior frontal, superior temporal and insular cortex, and hippocampus). Conclusions These data suggest that the same clinical severity of dementia is associated with greater reductions in cerebral metabolism in men than in women suggesting a greater degree of brain reserve in men.     

Gender differences in the heritability of seasonal mood change

The study estimated gender differences in the magnitude of genetic and environmental influence in seasonal mood change. The self-report Seasonal Pattern Assessment Questionnaire (SPAQ) was completed by 339 volunteer reared-together twin pairs (187 monozygotic pairs, 152 dizygotic pairs) and analysed using biometric genetic models. The SPAQ yields a global seasonality score (GSS) which is an index of change in sleep patterns, social activities, mood, weight, appetite, and energy level. The GSS was significantly heritable among males and females, estimated to account for 69% and 45% of the total variance, respectively. For the individual symptoms, changes in sleep patterns, social activities, mood, appetite, and energy levels were accounted for primarily by additive genetic effects in both males (median, 45.5%) and females (median, 30.5%). For both sexes, weight changes were not heritable. Sex-by-genotype analyses suggested that the genetic factors influencing female seasonality may not be the same as those influencing male seasonality. ©1997 Elsevier Science Ireland Ltd.     

Gender differences in the psychopathology of depressed inpatients

Abstract. In the last few years there has been increased scientific effort to describe the gender–specific psychopathological features of depression. Until now these studies have not been entirely conclusive, which could be the result of methodological difficulties. This report investigates sex differences in the symptom presentation in an inpatient population: 104 female and 113 male patients suffering from a depressive episode according to ICD–10 were admitted to the inpatient treatment at the Department of General Psychiatry in Vienna. A psychopathological rating according to the standardized documentation system of the AMDP (Association for Methodology and Documentation in Psychiatry) was performed at admission and discharge. At admission into the hospital women tended to show more affective lability (p = 0.025), whereas men had higher scores in affective rigidity (p = 0.032), blunted affect (p = 0.002), decreased libido (p = 0.028), hypochondriasis (p = 0.016) and hypochondriac delusions (p = 0.039). At discharge from the hospital women had significantly higher scores in dysphoria (p = 0.010), while men were more prone to have compulsive impulses (p = 0.030). Although our results were obtained in a selected sample of inpatients at a university hospital, they are indicative of psychopathological differences between men and women in the core symptoms of depression. These differences may influence diagnostic practice and gender specific treatment of depression.*Both authors contributed equally     

Gender differences in the phenomenology of bipolar disorder

OBJECTIVES: To investigate gender differences in the phenomenology of episodes in bipolar disorder as according to ICD-10. METHODS: All patients who got a diagnosis of a manic episode/bipolar disorder in a period from 1994 to 2002 at the first outpatient treatment ever or at the first discharge from psychiatric hospitalization ever in Denmark were identified in a nationwide register. RESULTS: Totally, 682 outpatients and 1037 inpatients got a diagnosis of a manic episode/bipolar disorder at the first contact ever. Significantly more women were treated as outpatients than as inpatients. Women were treated for longer periods as inpatients but not as outpatients. In both settings, the prevalence of depressive versus manic/mixed episodes was similar for men and women and the severity of manic episodes (hypomanic /manic without psychosis/manic with psychosis) and the severity of depressive episodes (mild/moderate/severe without psychosis/severe with psychosis) did not differ between genders. The prevalence of psychotic symptoms at first contact was the same for both genders. Among patients treated in outpatient settings more men than women presented with comorbid substance abuse and among patients treated during hospitalization more women than men presented with mixed episodes. CONCLUSIONS: Besides differences in the prevalence of mixed episodes and comorbid substance abuse few gender differences are found among patients presenting with a manic episode/bipolar disorder at first contact in psychiatric inpatient or outpatient hospital settings.