Riecher-Rossler A, Hafner H. Gender aspects in schizophrenia: bridging the border between social and biological psychiatry. Acta Psychiatr Scand Suppl 407: 58-62

Central Institute of Mental Health, Mannheim, Baden-Württemberg, Germany
Acta psychiatrica Scandinavica. Supplementum 02/2000; 102(407):58-62. DOI: 10.1034/j.1600-0447.2000.00011.x
Source: PubMed


This paper tries to show that gender differences in mental diseases are a valuable paradigm for research into the interplay between biological and psychosocial factors--not only regarding pathogenetic mechanisms, but also concerning therapeutic approaches.
Based on relevant literature, this topic is highlighted using schizophrenia as an example.
Schizophrenic disorders show a later age of onset in women and a slightly better course, especially in young women. As to pathogenesis, there is some evidence that the age difference might be due at least partly to the female sex hormone oestradiol being a protective factor. Differences in course might also have to do with this biological factor, but at the same time with the psychosocial advantages of a higher age of onset and other psychosocial factors. Concerning therapy, these gender differences have important implications for pharmacotherapy, but also psychotherapy and social measures.
A gender-sensitive approach in psychiatry improves our understanding of mental illness and our therapeutic strategies and at the same time illustrates that comprehensive psychiatry cannot be practised in artificially separated 'drawers' called 'biological psychiatry', on one hand, and 'social psychiatry' on the other.

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Available from: Anita Riecher-Rössler,
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    • "Several studies have found gender differences in negative symptoms, showing that in males, they were more severe [21] [22] [23]. Moreover, in a sample of 276 people with schizophrenia , Galderisi et al. [10] found that men scored higher in disorganization and negative symptoms. "

    04/2012; 2012:694870. DOI:10.1155/2012/694870
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    • "Several studies have found gender differences in negative symptoms, showing that in males, they were more severe [21] [22] [23]. Moreover, in a sample of 276 people with schizophrenia , Galderisi et al. [10] found that men scored higher in disorganization and negative symptoms. "
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    ABSTRACT: Recent studies have begun to look at gender differences in schizophrenia and first-episode psychosis in an attempt to explain the heterogeneity of the illness. However, a number of uncertainties remain. This paper tries to summarize the most important findings in gender differences in schizophrenia and first-psychosis episodes. Several studies indicate that the incidence of schizophrenia is higher in men. Most of the studies found the age of onset to be earlier in men than in women. Findings on symptoms are less conclusive, with some authors suggesting that men suffer more negative symptoms while women have more affective symptoms. Premorbid functioning and social functioning seem to be better in females than males. However, cognitive functioning remains an issue, with lack of consensus on differences in neuropsychological profile between women and men. Substance abuse is more common in men than women with schizophrenia and first-episode psychosis. In terms of the disease course, women have better remission and lower relapse rates. Lastly, there is no evidence of specific gender differences in familial risk and obstetric complications. Overall, gender differences have been found in a number of variables, and further study in this area could help provide useful information with a view to improving our care of these patients.
    04/2012; 2012(1):916198. DOI:10.1155/2012/916198
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    • "marital status, living situation) and medication, the present results are also in perfect agreement with previous findings: Male patients are younger when the first psychotic episode occurs, are more frequently single, more often dependent on supported living conditions (e.g. residential homes) and show lower educational status [61,67,68]. Among the explanations for the observed gender differences in schizophrenia are the protective role of female hormones [69] and social aspects like earlier marriage of young women leading to a more protected environment at disease onset [13]. "
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    ABSTRACT: Schizophrenia is the collective term for an exclusively clinically diagnosed, heterogeneous group of mental disorders with still obscure biological roots. Based on the assumption that valuable information about relevant genetic and environmental disease mechanisms can be obtained by association studies on patient cohorts of ≥ 1000 patients, if performed on detailed clinical datasets and quantifiable biological readouts, we generated a new schizophrenia data base, the GRAS (Göttingen Research Association for Schizophrenia) data collection. GRAS is the necessary ground to study genetic causes of the schizophrenic phenotype in a 'phenotype-based genetic association study' (PGAS). This approach is different from and complementary to the genome-wide association studies (GWAS) on schizophrenia. For this purpose, 1085 patients were recruited between 2005 and 2010 by an invariable team of traveling investigators in a cross-sectional field study that comprised 23 German psychiatric hospitals. Additionally, chart records and discharge letters of all patients were collected. The corresponding dataset extracted and presented in form of an overview here, comprises biographic information, disease history, medication including side effects, and results of comprehensive cross-sectional psychopathological, neuropsychological, and neurological examinations. With >3000 data points per schizophrenic subject, this data base of living patients, who are also accessible for follow-up studies, provides a wide-ranging and standardized phenotype characterization of as yet unprecedented detail. The GRAS data base will serve as prerequisite for PGAS, a novel approach to better understanding 'the schizophrenias' through exploring the contribution of genetic variation to the schizophrenic phenotypes.
    BMC Psychiatry 11/2010; 10(1):91. DOI:10.1186/1471-244X-10-91 · 2.21 Impact Factor
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