Fondation FondaMental, Créteil, France.
Fondation FondaMental, Créteil, France; Pôle Psychiatrie Universitaire, CHU Sainte-Marguerite, F-13274 Marseille cedex 09, France.
Schizophr Res. 2018 May;195:357-365. doi: 10.1016/j.schres.2017.09.027. Epub 2017 Sep 30.
Sex differences can yield important clues regarding illness pathophysiology and its treatment. Schizophrenia (SZ) has a lower incidence rate, and a better prognosis, in women versus men. The present study investigated the cognitive profiles of both sexes in a large multi-centre sample of community-dwelling SZ patients.
544 community-dwelling stable SZ subjects (141 women and 403 men; mean age 34.5±12.1 and 31.6±8.7years, respectively) were tested with a comprehensive battery of neuropsychological tests.
Although community-dwelling SZ men had more risk factors for impaired cognition (including first-generation antipsychotics administration and comorbid addictive disorders), women had lower scores on a wide range of cognitive functions, including current and premorbid intellectual functioning, working memory, semantic memory, non-verbal abstract thinking and aspects of visual exploration. However, women scored higher in tests of processing speed and verbal learning, as well as having a lower verbal learning bias. No sex difference were evident for visuospatial learning abilities, cued verbal recall, sustained attention and tests of executive functions, including cognitive flexibility, verbal abstract thinking, verbal fluency and planning abilities.
Sex differences are evident in the cognitive profiles of SZ patients. The impact on daily functioning and prognosis, as well as longitudinal trajectory, should be further investigated in the FACE-SZ follow-up study. Sex differences in cognition have implications for precision-medicine determined therapeutic strategies.
Given the restricted age range of the sample, future research will have to determine cognitive profiles across gender in late onset SZ.
性别差异可以为疾病的病理生理学及其治疗提供重要线索。与男性相比，女性精神分裂症（SZ）的发病率较低，预后较好。本研究在一个大型多中心社区精神分裂症患者样本中，调查了两性的认知特征。
对 544 名社区居住的稳定 SZ 受试者（141 名女性和 403 名男性；平均年龄分别为 34.5±12.1 和 31.6±8.7 岁）进行了全面的神经心理学测试。
尽管社区居住的 SZ 男性存在更多认知障碍的风险因素（包括第一代抗精神病药物治疗和合并成瘾障碍），但女性在广泛的认知功能方面得分较低，包括当前和发病前的智力功能、工作记忆、语义记忆、非言语抽象思维和视觉探索的各个方面。然而，女性在处理速度和词语学习测试中的得分更高，并且词语学习偏差较低。在视觉空间学习能力、线索词语回忆、持续注意力和执行功能测试（包括认知灵活性、词语抽象思维、词语流畅性和计划能力）中，没有性别差异。
SZ 患者的认知特征存在性别差异。在 FACE-SZ 随访研究中，应进一步研究这些差异对日常生活功能和预后的影响，以及纵向轨迹。认知方面的性别差异对基于精准医学的治疗策略具有重要意义。
由于样本的年龄范围有限，未来的研究将不得不确定性别在迟发性 SZ 中的认知特征。
