Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T09:53:57.197Z Has data issue: false hasContentIssue false
  • English
  • Français

Gender and mortality in schizophrenia: do women act like men?

Published online by Cambridge University Press:  09 July 2009

J. M. Goldstein ,
S. L. Santangelo ,
J. Simpson  and
M. T. Tsuang
J. M. Goldstein*
Affiliation:
Department of Psychiatry, Harvard Medical School, Division of Psychiatric Epidemiology and Genetics, Brockton-West Roxbury VA Medical Center; Harvard Program in Psychiatric Epidemiology, Harvard School of Public Health, Mass., USA
S. L. Santangelo
Affiliation:
Department of Psychiatry, Harvard Medical School, Division of Psychiatric Epidemiology and Genetics, Brockton-West Roxbury VA Medical Center; Harvard Program in Psychiatric Epidemiology, Harvard School of Public Health, Mass., USA
J. Simpson
Affiliation:
Department of Psychiatry, Harvard Medical School, Division of Psychiatric Epidemiology and Genetics, Brockton-West Roxbury VA Medical Center; Harvard Program in Psychiatric Epidemiology, Harvard School of Public Health, Mass., USA
M. T. Tsuang
Affiliation:
Department of Psychiatry, Harvard Medical School, Division of Psychiatric Epidemiology and Genetics, Brockton-West Roxbury VA Medical Center; Harvard Program in Psychiatric Epidemiology, Harvard School of Public Health, Mass., USA
*
1Address for correspondence: Dr Jill M. Goldstein, Psychiatry Service (116A), Brockton VA Medical Center, 940 Belmont Street, Brockton, MA 02401, USA.
Get access Rights & Permissions [Opens in a new window]

Synopsis

The effect of gender on mortality was explored for a sample of DSM-III diagnosed schizophrenics followed for up to 42 years. The data for 332 cases and 304 matched normal controls were from the retrospective cohort family studies, the Iowa 500 and non-500. Survival analysis and Cox regression models were used to test the effects of gender, illness status and their interaction on the risks for natural and unnatural deaths. The control men experienced significantly more unnatural deaths than the control women, which was not found for schizophrenic men and women. The unnatural death rate among schizophrenic women was similar to the rate for schizophrenic and control men, and significantly higher than for control women during the early phase of the illness. Findings suggest that some factors that predict suicide may be similar for schizophrenic women and men.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 4 , November 1993 , pp. 941 - 948
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allebeck, P. (1989). Schizophrenia: a life-shortening disease. Schizophrenia Bulletin 15, 81–89.CrossRefGoogle ScholarPubMed
Allbeck, P. & Wistedt, B. (1986). Mortality in schizophrenia: a ten-year follow-up based on the Stockholm County Inpatient Register. Archives of General Psychiatry 43, 650–653.CrossRefGoogle Scholar
Black, D. W. (1988). Mortality in schizophrenia – the Iowa recording-linkage study: a comparison with general population mortality. Psychosomatics 29, 55–60.CrossRefGoogle ScholarPubMed
Black, D. W., Warrack, G. & Winokur, G. (1985). The Iowa record-linkage study. III. Excess mortality among patients with ‘functional’ disorders. Archives of General Psychiatry 42, 82–88.CrossRefGoogle ScholarPubMed
Brook, O. H. (1985). Mortality in the long-stay population of Dutch mental hospitals. Acta Psychiatrica Scandinavica 71, 626–635.CrossRefGoogle ScholarPubMed
Buda, M., Tsuang, M. T. & Fleming, J. T. (1988). Causes of death in DSM-III schizophrenics and other psychotics (atypical group). A comparison with the general population. Archives of General Psychiatry 45, 283–285.CrossRefGoogle Scholar
Caldwell, C. B. & Gottesman, I. I. (1991). Schizophrenics kill themselves too: a review of risk factors for suicide. Schizophrenia Bulletin 16, 571–589.CrossRefGoogle Scholar
Cox, D. R. (1972). Regression models and life tables. Journal of the Royal Statistical Society B 34, 187–220.Google Scholar
Drake, R. E., Gates, C. & Cotton, P. (1986). Suicide among schizophrenics a comparison of attempters and completed suicides. British Journal of Psychiatry 149, 784–787.CrossRefGoogle ScholarPubMed
Eastwood, M. R., Stiasny, S., Meier, H. M. R. & Woogh, C. M. (1982). Mental illness and mortality. Comprehensive Psychiatry 23, 377–385.CrossRefGoogle ScholarPubMed
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 57–63.CrossRefGoogle ScholarPubMed
Goldstein, J. M., Faraone, S. V., Chen, W. J., Tolomiczencko, G. S. & Tsuang, M. T. (1990). Sex differences in the familial transmission of schizophrenia. British Journal of Psychiatry 156, 819–826.CrossRefGoogle ScholarPubMed
Goldstein, J. M., Tsuang, M. T. & Faraone, S. V. (1989). Gender and schizophrenia: implications for understanding the heterogeneity of the illness. Psychiatry Research 28, 243–253.CrossRefGoogle ScholarPubMed
Goldstein, J. M. (1993). The impact of gender on understanding the epidemiology of schizophrenia. In Gender and Psychopathology (ed. Seeman, M. V.). American Psychiatric Association Press: Washington, D.C.Google Scholar
Hassall, C., Prior, P. & Cross, K. W. (1988). A preliminary study of excess mortality using a psychiatric case register. Journal of Epidemiology and Community Health 42, 286–289.CrossRefGoogle ScholarPubMed
Haugland, G., Craig, T. J., Goodman, A. B. & Siegel, C. (1983). Mortality in the era of deinstitutionalization. American Journal of Psychiatry 140, 848–852.Google ScholarPubMed
Herrman, H. E., Baldwin, J. A. & Christie, D. (1983). A record-linkage study of mortality and general hospital discharge in patients diagnosed as schizophrenic. Psychological Medicine 13, 581–593.CrossRefGoogle ScholarPubMed
Hillard, J. R., Zung, W. W. K., Ramm, D., Holland, J. M. & Johnson, M. (1985). Accidental and homicidal death in a psychiatric emergency room population. Hospital and Community Psychiatry 36, 640–643.Google Scholar
Iacono, W. G. & Beiser, M. (1992). Are males more likely than females to develop schizophrenia. American Journal of Psychiatry 149, 1070–1074.Google ScholarPubMed
Johns, C. A., Stanley, M. & Stanley, B. (1986). Suicide in schizophrenia. Annals of the New York Academy of Science 487, 294–300.CrossRefGoogle ScholarPubMed
Kalbfleisch, J. D. & Prentice, R. L. (1980). The Statistical Analysis of Failure Time Data. Wiley: New York.Google Scholar
Kaplan, E. L. & Meier, P. (1958). Nonparametric estimation from incomplete observations. Journal of the American Statistical Association 53, 457–481.CrossRefGoogle Scholar
Kendler, K. K., Gruenberg, A. M. & Tsuang, M. T. (1985). Psychiatric illness in first-degree relatives of schizophrenic and surgical control patients. A family study using DSM-III criteria. Archives of General Psychiatry 42, 770–779.CrossRefGoogle ScholarPubMed
Lewine, R. J., Burbach, D. & Meltzer, H. Y. (1984). Effect of diagnostic criteria on the ratio of male to female schizophrenic patients. American Journal of Psychiatry 141, 84–87.Google ScholarPubMed
Morrison, J., Clancy, J., Crowe, R. & Winokur, G. (1972). The Iowa 500:I. Diagnostic validity in mania, depression, and schizophrenia. Archives of General Psychiatry 27, 457–461.CrossRefGoogle Scholar
Roy, A. (1982). Suicide in chronic schizophrenia. British Journal of Psychiatry 141, 171–177.CrossRefGoogle ScholarPubMed
Saugstad, L. & Ødegård, Ø. (1985). Recent rise in supposedly stress dependent causes of death in psychiatric hospitals in Norway indicating increased ‘stress’ in hospitals? Acta Psychiatrica Scandinavica 71, 402–404.CrossRefGoogle ScholarPubMed
Seeman, M. V. (1986). Current outcome in schizophrenia. Acta Psychiatrica Scandinavica 73, 609–617.CrossRefGoogle ScholarPubMed
Siede, H. (1973). Die derzeitige (1970). Situation an den psychiatrischen LKH Niedersachsen. Socialpsychiatrische Informationen 13, 10–23.Google Scholar
Simpson, J. C. (1988). Mortality studies in schizophrenia. In Handbook of Schizophrenia, Vol. 3: Nosology, Epidemiology and Genetics of Schizophrenia (ed. Tsuang, M. T. and Simpson, J. C.), pp. 245–273. Elsevier Science Publishers: Amsterdam.Google Scholar
Tsuang, M. T. (1978). Suicide in schizophrenics, manics, depressives, and surgical controls. A comparison with general population suicide mortality. Archives of General Psychiatry 35, 153–155.CrossRefGoogle ScholarPubMed
Tsuang, M. T. & Woolson, R. F. (1977). Mortality in patients with schizophrenia, mania, depression and surgical conditions. A comparison with general population mortality. British Journal of Psychiatry 130, 162–166.CrossRefGoogle ScholarPubMed
Tsuang, M. T. & Woolson, R. F. (1978). Excess mortality in schizophrenia and affective disorders. Do suicides and accidental deaths solely account for this excess? Archives of General Psychiatry 35, 1181–1185.CrossRefGoogle ScholarPubMed
Tsuang, M. T., Woolson, R. F. & Fleming, J. (1980 a). Causes of death in schizophrenia and manic depression. British Journal of Psychiatry 136, 239–242.CrossRefGoogle ScholarPubMed
Tsuang, M. T., Woolson, R. F. & Fleming, J. A. (1980 b). Premature deaths in schizophrenia and affective disorders. An analysis of survival curves and variables affecting the shortened survival. Archives of General Psychiatry 37, 979–983.CrossRefGoogle ScholarPubMed
Weiner, B. P. & Marvit, R. R. (1977). Schizophrenia in Hawaii: analysis of cohort mortality risk in a multi-ethnic population. British Journal of Psychiatry 131, 497–503.CrossRefGoogle Scholar
Wood, J. B., Evenson, R. C., Cho, D. W. & Hagan, B. J. (1985). Mortality variations among public mental health patients. Acta Psychiatrica Scandinavica 72, 218–229.CrossRefGoogle ScholarPubMed