P. Pancheri, A. Speca - Vol. 5, Dicembre 1999, num.4
Testo Immagini Bibliografia Summary Riassunto Indice
La schizofrenia: differenze di genere
Schizophrenia: gender related differences
Background: recent interest in psychopathological gender-related differences arose from findings of morphological brain differences between the two genders. Schizophrenia is one of the first domains where gender-related differences were sought. This paper analyses data gather to date on this subject.
Methods: at this aim, a careful "medline" was carried-out on gender-related differences in the incidence, age at onset, symptomatological picture, clinical course, outcome, drug treatment response, and brain morphology of schizophrenia.
Results: gender-related differences in schizophrenia were found regarding all investigated measures. The female gender was characterised by lower incidence, a later onset a greater proportion of diagnoses of paranoid schizophrenia, a lower incidence of negative symptoms, higher presence of persecutory delusions and dysphoric mood, less disorganised thought, greater anxiety, higher mood incongruence and more bizarre behaviour, better clinical course and outcome, better response to antipsychotics, to which females respond earlier and at lower doses than males, lower incidence of diffuse and specific brain abnormalities.
Conclusions: a possible explanation as to why schizophrenia in the female gender is less severe, has a better clinical course and a better outcome with respect to males could rely in differences in the neurological, neuroendocrine and endocrine asset between the two genders. These could act as protective factors that retard the onset of schizophrenia in females and reduce severity of clinical picture, and could allow for a better premorbid adaptation, that could account for better course and prognosis. This could be reflected into a need for targeting treatment according to gender, in order to obtain optimal treatment response.