title: Schizophrenia clinical symptom differences in women vs. men with and without a history of childhood physical abuse.
abstract: BACKGROUND
  Childhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia. A recent large population-based case-control study found that abuse may be a risk factor for schizophrenia in women, but not men. Given the sex differences in onset and clinical course of schizophrenia, we hypothesized that childhood abuse may cause phenotypic differences in the disorder between men and women.
  
  
  METHODS
  We examined the prevalence of childhood physical abuse in a cohort of men and women with schizophrenia and schizoaffective disorder. Specifically, we examined differences in positive, negative, cognitive and depressive symptoms in men and women who reported a history of childhood physical abuse. We recruited 100 subjects for a single visit and assessed a history of childhood physical abuse using the childhood trauma questionnaire (CTQ) and clinical symptoms and cognition using the brief psychiatric rating scale (BPRS), the calgary depression scale (CDS) and the repeatable battery of the assessment of neuropsychological status (RBANS) for cognition.
  
  
  RESULTS
  Ninety-two subjects completed the full CTQ with abuse classified as definitely present, definitely absent or borderline. Twelve subjects who reported borderline abuse scores were excluded. Of the 80 subjects whose data was analyzed, 10 of 24 (41.6 %) women and 11 of 56 (19.6 %) men reported a history of childhood physical abuse (χ(2) = 4.21, df = 1, p = 0.04). Women who reported such trauma had significantly more psychotic (sex by abuse interaction; F = 4.03, df = 1.76, p = 0.048) and depressive (F = 4.23, df = 1.76, p = 0.04) symptoms compared to women who did not have a trauma history and men, regardless of trauma history. There were no differences in negative or cognitive symptoms.
  
  
  CONCLUSIONS
  Women with schizophrenia and schizoaffective disorder may represent a distinct phenotype or subgroup with distinct etiologies and may require different, individually tailored treatments.
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Deanna L
authors.initials: DL
authors.lastname: Kelly
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Rowland
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Patchan
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Kelli
authors.initials: K
authors.lastname: Sullivan
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Earl
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Raley
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Feldman
authors.affiliation: Department of Psychiatry, Maryland Psychiatric Research Center, Spring Grove Hospital Grounds, University of Maryland School of Medicine, Box 21247, Baltimore, MD 21228 USA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: McMahon
keywords: Abuse; Gender; Schizophrenia; Sex; Trauma; Women