Harvard Medical School, Boston.
Department of Psychiatry, Cambridge Health Alliance, Cambridge, Massachusetts, USA.
Curr Opin Psychiatry. 2022 May 1;35(3):157-164. doi: 10.1097/YCO.0000000000000786. Epub 2022 Feb 11.
Psychiatric illnesses are very prevalent in the United States and impact women and men differently. In this review, we will explore some gender differences in the expression of psychopathology, discuss the most common serious mental illnesses (SMI) affecting women, and review treatment options according to specific life stages. We hope to raise awareness of these issues and consequently improve outcomes for women with serious mental illness.
SMI have different rates and are manifested differently in women and men because of biological, psychological, social, and cultural factors. Some SMI are more prevalent in women whereas others uniquely affect them during particular life stages. Even in disorders that have a similar prevalence in men and women or are more prevalent in men, the presentation, course, management, and repercussions can vary significantly between the two genders. Medical and psychiatric comorbidities, which directly influence treatment, prognosis, and disability, are more common in women.
Several differences in the gender expression of SMI have not yet been fully described. It is important to become familiar with important characteristics of SMI in women, including biological determinants, treatment differences, and psychosocial aspects. Recognizing gender biases, cultural considerations, and adaptive responses can help identify women at risk, promote early recognition of symptoms, and prompt interventions that may lead to improved outcomes.
精神疾病在美国非常普遍,对女性和男性的影响不同。在这篇综述中,我们将探讨精神病理学表现中的一些性别差异,讨论影响女性的最常见严重精神疾病(SMI),并根据特定的生命阶段回顾治疗选择。我们希望提高对这些问题的认识,从而改善女性严重精神疾病患者的结局。
由于生物、心理、社会和文化因素,SMI 在女性和男性中的发病率和表现不同。一些 SMI 在女性中更为普遍,而另一些则在女性特定的生命阶段对她们产生独特的影响。即使在男性和女性中患病率相似或在男性中更为普遍的疾病中,两性之间的表现、病程、管理和后果也可能有很大差异。直接影响治疗、预后和残疾的合并躯体疾病和精神疾病在女性中更为常见。
SMI 性别表达中的一些差异尚未得到充分描述。熟悉女性 SMI 的重要特征非常重要,包括生物学决定因素、治疗差异和心理社会方面。认识到性别偏见、文化因素和适应反应可以帮助识别有风险的女性,促进症状的早期识别,并促使采取干预措施,从而可能改善结局。