Seeman Mary V
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Expert Rev Neurother. 2021 Apr;21(4):443-453. doi: 10.1080/14737175.2021.1898947. Epub 2021 Mar 16.
: Most medical diagnoses present somewhat differently in men and women, more so at specific periods of life. Treatment effects may also differ. This is true for schizophrenia, where premorbid effects are experienced earlier in life in boys than in girls, and where symptoms and outcomes differ.: This review does not cover all the differences that have been reported between men and women but, instead, focuses on the ones that carry important implications for clinical care: effective antipsychotic doses, medication side effects, symptom fluctuation due to hormonal levels, comorbidities, and women's requirements for prenatal, obstetric, postpartum, and parenting support.: Of consequence to schizophrenia, sex-biased genes, epigenetic modifications, and sex steroids all impact the structure and function of the brain. Furthermore, life experiences and social roles exert major sex-specific influences. The co-morbidities that accompany schizophrenia also affect men and women to different degrees. This review offers several examples of sex-specific intervention and concludes that gold standard treatment must look beyond symptoms and address all the physiologic, psychologic, and social role needs of men and women suffering from this psychiatric disorder.
大多数医学诊断在男性和女性身上的表现有所不同，在生命的特定阶段差异更为明显。治疗效果也可能不同。精神分裂症就是如此，其病前影响在男孩身上比在女孩身上更早出现，而且症状和预后也有所不同。
本综述并未涵盖已报道的男性和女性之间的所有差异，而是侧重于那些对临床护理具有重要意义的差异：有效的抗精神病药物剂量、药物副作用、激素水平导致的症状波动、合并症，以及女性对产前、产科、产后和育儿支持的需求。
对精神分裂症而言，性别偏向基因、表观遗传修饰和性类固醇都会影响大脑的结构和功能。此外，生活经历和社会角色也会产生主要的性别特异性影响。精神分裂症伴随的合并症对男性和女性的影响程度也不同。本综述提供了几个性别特异性干预的例子，并得出结论，金标准治疗必须超越症状，满足患有这种精神疾病的男性和女性的所有生理、心理和社会角色需求。
