Weiser M, Reichenberg A, Rabinowitz J, Kaplan Z, Mark M, Nahon D, Davidson M
Chaim Sheba Medical Center, 52621, Tel Hahomer, Israel.
Schizophr Res. 2000 Oct 27;45(3):185-90. doi: 10.1016/s0920-9964(99)00190-5.
Despite significant research, there are still inconsistent findings regarding gender differences in cognitive performance in individuals already diagnosed with schizophrenia; studies have found that males suffering from schizophrenia are more, less or equally impaired compared with females. Gender differences in cognitive performance in individuals suffering from schizophrenia may be influenced by gender differences in premorbid cognitive performance; the very few and very small N studies published indicated that males have a poorer pre-morbid cognitive performance than females. This study examined the gender differences in premorbid cognition, utilizing cognitive assessments performed on female and male adolescents before induction into military service. The Israeli Draft Board Registry, which contains cognitive assessments equivalent to IQ scores on 16-18 year old Israeli adolescents, was linked with the Israeli National Psychiatric Hospitalization Case Registry, which records all psychiatric hospitalizations in the country. Scores on premorbid cognitive performance in schizophrenia were examined in 90 female-male case pairs matched for school attended as a proxy for socio-economic status. The mean age of first hospitalization was 20. 1+/-1.8 years of age for males and 19.6+/-1.8 years of age for females. A repeated-measures ANCOVA with age of first hospitalization and years of formal education as covariates, and controlling for gender differences in cognitive performance in healthy adolescents, revealed a significant difference in pre-morbid cognitive performance between males and females on all four cognitive measures [F(1,87)=8.07, P=0.006] with females scoring lower (worse) than males. In this national cohort, pre-morbid cognition was poorer in female, compared with male, adolescents who will suffer from schizophrenia in the future, a result consistent with some, but not all, similar studies. These results may be valid only for patients with first hospitalization around age 20. Hence, gender differences in premorbid cognition should be taken into account when assessing gender differences in cognition in schizophrenia.
尽管进行了大量研究，但对于已确诊精神分裂症患者认知表现的性别差异，仍存在不一致的研究结果；研究发现，与女性相比，患精神分裂症的男性认知受损程度可能更高、更低或相同。精神分裂症患者认知表现的性别差异可能受病前认知表现的性别差异影响；已发表的数量极少且样本量极小的研究表明，男性病前认知表现比女性差。本研究利用对即将入伍的青少年男女进行的认知评估，考察了病前认知的性别差异。以色列征兵委员会登记处包含对16 - 18岁以色列青少年相当于智商分数的认知评估，该登记处与记录该国所有精神病住院情况的以色列国家精神病住院病例登记处相关联。在90对按就读学校匹配以代表社会经济地位的男女病例组中，考察了精神分裂症病前认知表现得分。首次住院的平均年龄，男性为20.1±1.8岁，女性为19.6±1.8岁。以首次住院年龄和正规教育年限作为协变量，并控制健康青少年认知表现的性别差异，进行重复测量协方差分析，结果显示在所有四项认知测量指标上，男性和女性病前认知表现存在显著差异[F(1,87)=8.07，P = 0.006]，女性得分低于（更差）男性。在这个全国队列中，未来将患精神分裂症的女性青少年与男性青少年相比，病前认知更差，这一结果与部分但并非所有类似研究一致。这些结果可能仅对首次住院年龄在20岁左右的患者有效。因此，在评估精神分裂症认知的性别差异时，应考虑病前认知的性别差异。
