Giordano Giulia Maria, Bucci Paola, Mucci Armida, Pezzella Pasquale, Galderisi Silvana
Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy.
Front Psychiatry. 2021 Dec 22;12:789179. doi: 10.3389/fpsyt.2021.789179. eCollection 2021.
An extensive literature regarding gender differences relevant to several aspects of schizophrenia is nowadays available. It includes some robust findings as well as some inconsistencies. In the present review, we summarize the literature on gender differences in schizophrenia relevant to clinical and social outcome as well as their determinants, focusing on clinical variables, while gender differences on biological factors which may have an impact on the outcome of the disorder were not included herewith. Consistent findings include, in male with respect to female patients, an earlier age of illness onset limited to early- and middle-onset schizophrenia, a worse premorbid functioning, a greater severity of negative symptoms, a lower severity of affective symptoms and a higher rate of comorbid alcohol/substance abuse. Discrepant findings have been reported on gender differences in positive symptoms and in social and non-social cognition, as well as in functional outcome and rates of recovery. In fact, despite the overall finding of a more severe clinical picture in males, this does not seem to translate into a worse outcome. From the recent literature emerges that, although some findings on gender differences in schizophrenia are consistent, there are still aspects of clinical and functional outcome which need clarification by means of further studies taking into account several methodological issues.
如今有大量关于精神分裂症多个方面性别差异的文献。其中包括一些确凿的研究结果以及一些不一致之处。在本综述中，我们总结了与精神分裂症临床和社会结局及其决定因素相关的性别差异文献，重点关注临床变量，而可能影响该疾病结局的生物学因素方面的性别差异未在此纳入。一致的研究结果包括，相较于女性患者，男性精神分裂症患者发病年龄更早（仅限于早发型和中发型精神分裂症）、病前功能更差、阴性症状更严重、情感症状严重程度更低以及酒精/物质滥用共病率更高。关于阳性症状、社会和非社会认知、功能结局及康复率方面的性别差异，已有不同的研究结果报道。事实上，尽管总体上发现男性的临床症状更为严重，但这似乎并未转化为更差的结局。从最近的文献中可以看出，尽管关于精神分裂症性别差异的一些研究结果是一致的，但临床和功能结局的某些方面仍需要通过进一步研究来阐明，同时要考虑到几个方法学问题。
