Oslo University Hospital, Psychosis Research Unit, Oslo, Norway.
Neuropsychology. 2011 Jul;25(4):499-510. doi: 10.1037/a0022677.
To investigate sex differences in neurocognition and social functioning in schizophrenia and bipolar disorder and the possible role of sex as a moderator of this relationship.
Participants with schizophrenia (60 women/94 men), bipolar I disorder (55 women/51 men), and healthy controls (158 women/182 men) were assessed with an extensive neuropsychological test battery and a social functioning questionnaire.
We found significant main effects of sex for neuropsychological tests (p < .001, η² = 0.10) and social functioning (p < .001, η² = 0.05), with men scoring below women. Women performed better than men for all neuropsychological tests (except attention and working memory). Both clinical groups performed below healthy controls for all neuropsychological tests (except attention). Post hoc comparisons of persons with schizophrenia and healthy controls yielded significant interaction effects (p < .05) for three neuropsychological tests (California Verbal Learning Test II [CVLT-II], Color-Word Interference, and Interference/Switching), with men with schizophrenia being disproportionally disadvantaged compared with their female counterparts. Regression analyses investigating sex as a moderator between neurocognition and social functioning showed that neurocognition predicted social functioning in schizophrenia, whereas sex predicted social functioning in healthy controls. Sex was not a moderator in any of the three groups.
This study is the first to find neurocognitive sex differences for bipolar disorder and replicated previous findings for schizophrenia. The data did not support the hypothesis that sex is a moderator between neurocognition and social functioning. Clinical implications include the use of different cognitive remediation strategies based on sex.
探究精神分裂症和双相情感障碍患者的神经认知和社会功能的性别差异，以及性别是否可能作为调节这种关系的因素。
纳入精神分裂症患者（60 名女性/94 名男性）、双相情感障碍患者（55 名女性/51 名男性）和健康对照者（158 名女性/182 名男性），对他们进行了广泛的神经心理学测试和社会功能问卷评估。
我们发现，性别对神经心理学测试（p <.001，η² = 0.10）和社会功能（p <.001，η² = 0.05）有显著的主效应，男性的得分低于女性。女性在所有神经心理学测试（除注意力和工作记忆外）中的表现均优于男性。两个临床组在所有神经心理学测试（除注意力外）中的表现均低于健康对照组。对精神分裂症患者和健康对照组的事后比较得出，三个神经心理学测试（加利福尼亚语言学习测试第二版 [CVLT-II]、颜色-词语干扰和干扰/转换）的结果存在显著的交互效应（p <.05），男性精神分裂症患者与女性患者相比处于明显劣势。探讨性别作为神经认知和社会功能之间调节因素的回归分析表明，神经认知可以预测精神分裂症患者的社会功能，而性别可以预测健康对照组的社会功能。性别在这三个组中均不是调节因素。
本研究首次发现了双相情感障碍患者的神经认知性别差异，并重复了之前精神分裂症患者的研究结果。数据不支持性别是神经认知和社会功能之间调节因素的假设。临床意义包括根据性别使用不同的认知矫正策略。
