Gender differences in never-medicated first-episode schizophrenia and medicated chronic schizophrenia patients.
BACKGROUND
Schizophrenia shows gender differences in patients' clinical presentation, neurocognitive impairment, course, and treatment outcome. The aims of this study were to compare gender differences in clinical features and cognitive functioning in first-episode and chronic schizophrenia among Han Chinese inpatients.


METHODS
We compared gender differences in 262 unmedicated first-episode schizophrenia and 960 chronic schizophrenia inpatients (diagnosed according to DSM-IV) to 804 matched healthy controls on sociodemographic characteristics, smoking behavior, and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Patients were also rated on the Positive and Negative Syndrome Scale. The study was conducted from December 2006 to May 2008.


RESULTS
Schizophrenia first occurred in both first-episode and chronic schizophrenia patients at a significantly earlier age in male than female patients (P < .05 and P < .001, respectively). The paranoid subtype of schizophrenia was more common in female patients only in chronic schizophrenia, not first-episode patients. Further, cigarette smoking was more common in male than female patients from both patient groups, and, among men, more chronic schizophrenia patients than controls smoked, while among women, fewer chronic schizophrenia patients than controls smoked. Female chronic schizophrenia patients had more severe positive and general psychopathological symptoms, whereas male patients had more severe negative symptoms. By contrast, first-episode schizophrenia patients showed no gender differences in symptoms and severity. Both first-episode and chronic schizophrenia patients performed worse than controls on most of the cognitive tasks. RBANS attention, delayed memory, and immediate memory were less impaired in female than male chronic schizophrenia patients, and first-episode schizophrenia patients showed no gender differences.


CONCLUSIONS
Chronic schizophrenia patients have notable gender differences in the age at onset, smoking, symptom severity, and cognitive function favoring women, but first-episode schizophrenia patients show few gender differences.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texasm, USA. xyzhang@bcm.edu
Xiang Yang
XY
Zhang
Da Chun
DC
Chen
Mei Hong
MH
Xiu
Fu De
FD
Yang
Colin N
CN
Haile
Therese A
TA
Kosten
Thomas R
TR
Kosten
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002681:China; D002908:Chronic Disease; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D012563:Schizophrenia, Paranoid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D055815:Young Adult
D014150:Antipsychotic Agents