A. Palma, M. Biondi, P. Pancheri - Vol. 5, Dicembre 1999, num.4
Testo Immagini Bibliografia Summary Riassunto Indice
Le differenze di genere al MMPI2: Uno Studio
Sperimentale in Pazienti con Disturbi dell’Area Schizofrenica e dell’Area
Depressiva (DSM-III-R)
Gender differences on the MMPI-2. An experimental study in patients with
disorders of the schizophrenic or depressive domains
Background: in literature the clinical heterogeneity of some psychiatric disorders sometimes finds a confirmation in biological and anatomic-functional differences which emerge from the study of the disease in comparison with the sexual gender variable. The clinical differences – in the beginning, course, and responses to the therapies of schizophrenia and depression – are often explained on the basis of hormonal factors, of morph-functional or of different cerebral anatomy existing between males and females. In most of the studies references are made to diagnoses worked out according to criteria exclusively categorical. At present, it seems even reduced the study of psychiatric disorders according to a dimensional approach and to differences of gender that allow to set the relative weigh of qualitative, quantitative, and temporal aspects of the different psychopathological components of schizophrenic and depressive disorders.
Aim and Methods: the research aims to evaluate if, independently from a psychiatric categorical evaluation, there exist psychopathological aspects which vary or more in general are significantly modulated from the sexual gender. A total of 208 out-patients (104 males and 104 females) – 34 (17 males and 17 females) with a diagnosis of the schizophrenic area, and 174 (87 males and 87 females) with a diagnosis of the depressive area – were subjected to facility psychometric evaluation with the Multiphasic Personality Inventory 2nd version (MMPI-2). Evaluations were carried out in the out-patient the 3rd Clinic of Psychiatry of Rome: for all subjects it was their first examination, and in the study included were only those who didn not show comorbidity with other psychiatric and somatic disorders. Diagnoses were made according to the criteria of DSM-III-R, in the absolute respect of the test MMPI-2.
Results: statistic analysis revealed that in subjects with disorders in the schizophrenic area, males are middle-aged persons, a rate of school attendance slightly inferior and a distribution of the civil state similar to females. Still in this diagnostic area the psychometric profile of MMPI-2 it delineates in females a prevalence of emotional and anxious components which are highlighted , in basic scales, by higher scores in the Hs, D, Hy, Pt scales, and, in a lower measure in content scales for higher scores in ANX, DEP scales. The group of patients with diagnosis in the depressive area have shown an almost overlapping clinical profile of the basic scales between the two sexes, except for the Sc scale, which was found to be significantly increased in females. Concerning content scales, males with depression have shown a profile on the whole higher compared to females with a general slight superiority of almost all scores, except for HEA, where the prevalence has been feminine. Males scored significanthy higer on the DEP (p = .0358), on the ANG (p = .0235), and on the TPA scale with p = .0368.
Conclusions: results show that in the schizophrenic area females, compared to males, have on average a clinical profile more "disordered" in the neurotic area (Hs, D, Hy) with higher scores in content scales for depression (DEP) and for anxiety (ANX). The highest peaks correspond both in males and in females to clinical scales 2-6-8. The main datum relevant to disorders in the schizophrenic area seems in tune with what is described in literature. Schizophrenia in women seems to have a "softer" and more "emotional" clinical presentation, with symptoms in the relational (Hy scale) and somatic (Hs scale) area both close in expression to the sufferance of a "neurotic" kind. It has to be noticed that the MMPI feminine profile has a code type 2-8-3 and, among the scales that characterize the psychotic component, only the Pa seems the highest. In males, instead, the symptomatological profile seems more "nuclear", with an emotional area less differentiated compared to the other scales. In regard to the analysis of a group with a depressive area diagnosis, the average profile of the clinical scales of MMPI-2 in males and females have both a code-type 2-8 with no substantial differences, except for a significantly higher score in the validity scale K and in the basic scale Sc in females. Yet, the most interesting datum seems to result from the content scales. Males included in depressive disorders area have significantly higher scores for content scales, respectively for Depression, DEP scale, and for the Anger-Aggressivenessdimension, ANG scale, and a tendency to an carcer pursuing behavior, TPA scales. Depression associated with anger in the content scales of MMPI-2, with a lower score of the K scale is in full agreement with the epidemiological evidence of a higher risk of suicide in men than in women.