Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States.
Department of Psychiatry, Worcester Recovery Center and Hospital, Worcester, MA, United States.
Handb Clin Neurol. 2020;175:315-333. doi: 10.1016/B978-0-444-64123-6.00022-9.
Since its earliest conceptualization, schizophrenia has been considered a disorder of "young men." Contemporary research suggests that there are sex differences in schizophrenia that are both transdiagnostic and representative of general sex/gender differences across the psychopathology spectrum. This chapter selectively summarizes representative sex/gender differences in clinical expression, epidemiology, risk factors, treatment, as well as course and outcome in schizophrenia. The consistent sex differences found, such as onset age, generic brain anomalies, and hormonal involvement, are not specific to schizophrenia or necessarily to psychopathology. It is suggested that in working with those diagnosed as meeting the current criteria for schizophrenia, clinicians adopt a transdiagnostic framework informed by sex and gender role processes.
自其最初概念化以来,精神分裂症一直被认为是“年轻男性”的疾病。当代研究表明,精神分裂症存在性别差异,这些差异既具有跨诊断意义,又代表了整个精神病理学谱系中的一般性别差异。本章选择性地总结了精神分裂症临床表现、流行病学、风险因素、治疗以及病程和转归方面的代表性性别差异。发现的一致性别差异,如发病年龄、一般大脑异常和激素参与,不仅与精神分裂症有关,而且与精神病理学有关。有人建议,在与那些被诊断为符合当前精神分裂症标准的人合作时,临床医生应采用性别和性别角色过程为依据的跨诊断框架。