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Sex and Schizophrenia: Effects of Diagnostic Stringency, and Associations with Premorbid Variables

Published online by Cambridge University Press:  02 January 2018

David J. Castle ,
Simon Wessely  and
Robin M. Murray
David J. Castle*
Affiliation:
Institute of Psychiatry and King's College Hospital, London
Simon Wessely
Affiliation:
Institute of Psychiatry and King's College Hospital, London
Robin M. Murray
Affiliation:
Institute of Psychiatry and King's College Hospital, London
*
∗Genetics Section, Institute of Psychiatry, De Crespigny Park, London SE5 8AZ
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Abstract

In a case-record study, all first-contact patients with non-affective functional psychosis from a defined area over 20 years were diagnosed according to operational criteria of varying stringency and emphasis, and incidence rates for each set of criteria determined by sex and age at onset; data on premorbid adjustment were also analysed by sex and age at onset. The overall first-contact incidence of non-affective functional psychosis was approximately equal in men and women; however, the ratio of male to female incidence rates rose progressively when RDC (1.2), DSM-III-R (1.3), DSM-III (2.2), and Feighner (2.5) criteria for schizophrenia were applied. Schizophrenia was most common in young males and least common in older males, with females occupying an intermediate position. Schizophrenia in young males, particularly when stringently defined, was especially likely to be associated with single status, poor work and social adjustment, and premorbid personality disorder. The results suggest that schizophrenia syndrome is heterogeneous, and young males are especially prone to a severe neurodevelopmental form of illness associated with premorbid deficits.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 5 , May 1993 , pp. 658 - 664
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Angermeyer, M. C. & Kuhn, L. (1988) Gender differences in age at onset of schizophrenia: an overview. European Archives of Psychiatry and Neurological Sciences, 237, 351–364.Google Scholar
Angermeyer, M. C., Goldstein, J. M. & Kuhn, L. (1989) Gender differences in schizophrenia: rehospitalisation and community survival. Psychological Medicine, 19, 365–382.CrossRefGoogle Scholar
Angermeyer, M. C., Kuhn, L. & Goldstein, J. M. (1990) Gender and the course of schizophrenia: differences in treated outcomes. Schizophrenia Bulletin, 16, 293–307.Google Scholar
Castle, D. J. & Murray, R. M. (1991) The neurodevelopmental basis of sex differences in schizophrenia. Psychological Medicine, 21, 565–575.Google Scholar
Castle, D. J. & Murray, R. M. & Howard, R. (1992) What do we know about the aetiology of late-onset schizophrenia? European Psychiatry, 7, 99–108.Google Scholar
Castle, D. J. & Murray, R. M. & Howard, R., Wessely, S., Der, G., et al (1991) The incidence of operationally defined schizophrenia in Camberwell, 1965 to 1984. British Journal of Psychiatry, 159, 790–794.Google Scholar
Dohrenwend, B. S. & Dohrenwend, B. P. (1976) Sex differences in psychiatric disorders. American Journal of Sociology, 81, 1447–1454.CrossRefGoogle ScholarPubMed
Feighner, J. P., Robins, E., Guze, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Flor-Henry, P. (1985) Schizophrenia: sex differences. Canadian Journal of Psychiatry, 30, 319–322.Google Scholar
Goldstein, J. M. & Tsuang, M. T. (1990) Gender and schizophrenia: an introduction and synthesis of findings. Schizophrenia Bulletin, 16, 179–183.CrossRefGoogle Scholar
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.Google Scholar
Hafner, H. (1987) Epidemiology of schizophrenia. In Search for the Causes of Schizophrenia (eds Hafner, H., Gattaz, W. F. & Janzarik, W.). Berlin: Springer-Verlag.Google Scholar
Harris, M. J. & Jeste, M. J. (1988) Late onset schizophrenia: an overview. Schizophrenia Bulletin, 14, 39–55.CrossRefGoogle ScholarPubMed
Holden, N. (1987) Late paraphrenia or the paraphrenias? A descriptive study with a 10-year follow-up. British Journal of Psychiatry, 150, 635–639.Google Scholar
Katschnig, H. & Lenz, G. (1988) Are sex differences in age at onset of schizophrenia related to phenomenological subtypes? Schizophrenia Research, 1, 111–112.Google Scholar
Kraepelin, E. (1896) Psychiatrie: ein Lehrbuch für Studirende und Aertze. Leipzig: Barth.Google Scholar
Lewine, R. J. (1981) Sex differences in schizophrenia: timing or subtypes? Psychological Bulletin, 90, 432–444.Google Scholar
Lewine, R. J. (1988) Gender and schizophrenia. In Handbook of Schizophrenia, Vol. 3 (ed. Nasrallah, H. A.). Amsterdam: Elsevier.Google Scholar
Lewine, R. J., Strauss, J. S. & Gift, T. E. (1981) Sex differences in age at first hospital admission for schizophrenia: fact or artifact? American Journal of Psychiatry, 138, 440–444.Google Scholar
Lewine, R. J., Strauss, J. S. & Gift, T. E., Burbach, D. & Meltzer, H. Y. (1984) Effect of diagnosis criteria on the ratio of male to female schizophrenic patients. American Journal of Psychiatry, 141, 84–87.Google Scholar
Loranger, A. W. (1984) Sex differences in age at onset of schizophrenia. Archives of General Psychiatry, 41, 157–161.Google Scholar
McGuffin, P., Farmer, A. E. & Harvey, I. (1991) A polydiagnostic application of operational criteria in psychotic illness: development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764–770.Google Scholar
Pearlson, G., Kreger, L., Rabins, P. V., et al (1984) A chart review study of late-onset and early-onset schizophrenia. American Journal of Psychiatry, 146, 1568–1574.Google Scholar
Rabins, P., Pauker, S. & Thomas, J. (1984) Can schizophrenia begin after age 44? Comprehensive Psychiatry, 25, 290–293.CrossRefGoogle ScholarPubMed
Riecher, A., Maurer, K., Loffler, W., et al (1989) Schizophrenia - a disease of young single males? European Archives of Psychiatry and Neurological Sciences, 239, 210–212.Google Scholar
Rosenthal, D. (1970) Genetic Theory and Abnormal Behaviour. New York: McGraw Hill.Google Scholar
Rothman, K. (1986) Modem Epidemiology. Boston: Little, Brown.Google Scholar
Seeman, M. V. (1982) Gender differences in schizophrenia. Canadian Journal of Psychiatry, 27, 107–111.Google Scholar
Shimizu, A., Kurachi, M., Noda, M., et al (1988) Influence of sex on age at onset of schizophrenia. Japanese Journal of Psychiatry and Neurology, 42, 35–40.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research Diagnostic Criteria (RDC): Rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Wessely, S., Castle, D., Der, G., et al (1991) Ethnicity and schizophrenia: a case control study. British Journal of Psychiatry, 159, 795–801.Google Scholar
Wing, J. K. & Hailey, A. M. (1972) Evaluating a Community Psychiatric Service: The Camberwell Register, 1964-1971. London: Oxford University Press.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO.Google Scholar
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