Sajatovic Martha, Sultana Dilara, Bingham C Raymond, Buckley Peter, Donenwirth Karl
Department of Psychiatry, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Int J Geriatr Psychiatry. 2002 Jun;17(6):542-8. doi: 10.1002/gps.640.
This report is an analysis of gender related differences in clinical characteristics and hospital based health resource utilization among older adults with schizophrenia and schizoaffective disorder in an acute care, state hospital over a one-year period.
This retrospective record review is an analysis of age of illness onset, psychiatric and medical comorbidity, hospital utilization, and psychotropic medication use.
There were a total of 66 individuals with either schizophrenia or schizoaffective disorder. Mean age of this group was 55.2 +/- 4.62 years. Women were significantly over-represented among individuals with late onset schizophrenia and schizoaffective disorder. Men with schizophrenia had more comorbid substance abuse compared to women with schizophrenia (p < 0.05). Women and men did not differ significantly in hospital length of stay, amount or type of antipsychotic medication prescribed, or in utilization of seclusion/restraint in hospital. Both genders had substantial utilization of antipsychotic medication. Use of conventional antipsychotic medication monotherapy was always associated with use of anti-extrapyramidal symptom (anti-EPS) medication, while use of atypical antipsychotic medication monotherapy was more rarely associated with use of anti-EPS medication.
In later life, women and men may have some areas of differing health care needs. Women in particular may benefit from psychoeducational approaches that address the experience of psychiatric illness of relatively recent onset (for example, symptom identification and acceptance of illness). Men may benefit from particular emphasis on treatment of comorbid substance abuse disorders.
本报告分析了在一家急性护理州立医院中，患有精神分裂症和分裂情感性障碍的老年人在临床特征以及基于医院的卫生资源利用方面的性别差异，研究为期一年。
本回顾性记录审查分析了发病年龄、精神和躯体共病情况、医院利用情况以及精神药物使用情况。
共有66例患有精神分裂症或分裂情感性障碍的患者。该组的平均年龄为55.2±4.62岁。在晚发性精神分裂症和分裂情感性障碍患者中，女性的占比显著过高。与患有精神分裂症的女性相比，患有精神分裂症的男性有更多的物质滥用共病情况（p<0.05）。女性和男性在住院时间、所开具的抗精神病药物的数量或类型，或在医院使用隔离/约束措施方面没有显著差异。两性对抗精神病药物的使用都很普遍。使用传统抗精神病药物单一疗法总是与使用抗锥体外系症状（anti-EPS）药物相关，而使用非典型抗精神病药物单一疗法与使用anti-EPS药物的相关性则较低。
在晚年，女性和男性可能在一些医疗保健需求方面存在差异。特别是女性可能会从针对近期发病的精神疾病经历的心理教育方法中受益（例如，症状识别和对疾病的接受）。男性可能会从特别强调对共病物质滥用障碍的治疗中受益。
