Department of Psychiatry, Gazi University Hospital, Ankara, Turkey.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
Schizophr Res. 2022 May;243:120-137. doi: 10.1016/j.schres.2022.02.039. Epub 2022 Mar 11.
Various environmental exposures have been associated with psychosis spectrum disorder. However, the role of gender in this association has received little attention. Therefore, we conducted a systematic review to evaluate gender-related differences and identified 47 research articles investigating the associations of psychosis with childhood adversity, substance use, urbanicity, migration, season of birth, and obstetric complication in the PubMed database. The findings suggest that childhood abuse may be more strongly associated with a risk to develop psychosis and an earlier age at onset of illness in women than in men. Furthermore, childhood adversity has been associated with the severity of different symptom dimensions in men and women. Growing up in an urban environment and immigration are more strongly associated with psychosis risk in men than in women. Despite a higher prevalence of substance abuse comorbidity in men diagnosed with psychotic disorders, it appears that the association between substance use and psychosis risk may be stronger in women. These findings should be evaluated with caution considering several methodological limitations, limited number of studies, and lack of consistency across results. Overall, although further investigation is needed, our review shows that gender-related differences in the associations of environmental exposures with psychosis expression may exist.
各种环境暴露都与精神分裂症谱系障碍有关。然而，性别在这种关联中的作用却很少受到关注。因此，我们进行了一项系统评价，以评估与性别相关的差异，并在 PubMed 数据库中确定了 47 篇研究文章，这些文章调查了精神分裂症与儿童期逆境、物质使用、城市化、移民、出生季节和产科并发症的关联。研究结果表明，与男性相比，女性的童年虐待可能与患精神病的风险更高和发病年龄更早有关。此外，童年逆境与男女不同症状维度的严重程度有关。在城市环境中长大和移民与男性患精神病的风险比女性更高有关。尽管男性精神障碍患者物质滥用共病的患病率更高，但在女性中，物质使用与患精神病风险之间的关联似乎更强。考虑到多种方法学限制、研究数量有限以及结果缺乏一致性，这些发现应谨慎评估。总的来说，尽管需要进一步调查，但我们的综述表明，环境暴露与精神分裂症表现之间的关联可能存在性别差异。
