Age of onset symptoms and gender in schizophrenic spectrum disorders
Abstract
Introduction. Some controversy exists concerning whether the onset of schizophrenia and some clinical characteristics of the disorder are different between males and females.
Objective. The relationship between sex, age at onset and negative symptoms was evaluated in patients with schizophrenic spectrum disorders.
Materials and methods. A sample of 225 patients (89 women and 136 men) were diagnosed for schizophrenia between 2008 and 2009. Each was compared for age at onset of symptoms and SANS score (Scale for the Assessment of Negative Symptoms). Kernel density estimators were used to evaluate characteristics of age of onset with respect to gender. Parameters of the mixed distributions were estimated via maximum-likelihood algorithms. Relationships between negative symptoms score and age of onset were evaluated using multiple regression analysis.
Results. A significant difference was found in age at onset across gender (mean age of 24.5 years in men, 27.5 years in women). An association was found between gender and early onset of symptoms, with early onset occurring more frequently in male patients. Density estimates for age at onset suggested a mixture model with three components having as parameters: m1=21.55 +/- SD 5.25; m2=29.54 +/-SD 7.22; m3=40.01 +/- 3.98. When density estimates took into account gender, two bimodal structureswere found--(1) men with the lowest mean (18.0 years) and (2) the highest mean in middle-aged women (41.0 years). Regression coefficients suggested an increase in negative symptoms as time of disease increased.
Conclusion. The hypothesis was supported that a relationship exists between age of onset of symptoms, gender and clinical characteristics in patients with schizophrenic spectrum disorders, showing that men have an early onset an a more deteriorating course than women.
Downloads
References
Abel KM, Drake R, Goldstein JM. Sex differences in schizophrenia. Int Rev Psychiatry. 2010;22:417-28. doi: http://dx.doi.org/10.3109/09540261.2010.515205
Aleman A, Kahn RS, Selten JP. Sex differences in the risk of schizophrenia: Evidence from meta-analysis. Arch Gen Psychiatry. 2003;60:565-71. doi: http://dx.doi.org/10.1001/archpsyc.60.6.565
Castle DJ, Murray RM. The epidemiology of late-onset schizophrenia. Schizophr Bull. 1993;19:691-700. PMid:8303220
Hambrecht M, Maurer K, Hafner H, Sartorius N. Transnational stability of gender differences in schizophrenia? An analysis based on the WHO study on determinants of outcome of severe mental disorders. Eur Arch Psychiatry Clin Neurosci. 1992;242:6-12. doi: http://dx.doi.org/10.1007/BF02190336
Lindstrom LH. Clinical and biological markers for outcome in schizophrenia: A review of a longitudinal follow-up study in Uppsala schizophrenia research project. Neuropsychopharmacology. 1996;14(Suppl.):23S-6. doi: http://dx.doi.org/10.1016/0893-133X(95)00201-N
Hafner H, Hambrecht M, Loffler W, Munk-Jorgensen P, Riecher-Rossler A. Is schizophrenia a disorder of all ages? A comparison of first episodes and early course across the life-cycle. Psychol Med. 1998;28:351-65. doi: http://dx.doi.org/10.1017/S0033291797006399
Kao YC, Liu YP. Effects of age of onset on clinical characteristics in schizophrenia spectrum disorders. BMC Psychiatry. 2010;10:63. doi: http://dx.doi.org/10.1186/1471-244X-10-63
Gureje O, Bamidele RW. Gender and schizophrenia: Association of age at onset with antecedent, clinical and outcome features. Aust N Z J Psychiatry. 1998;32:415-23. doi: http://dx.doi.org/10.3109/00048679809065536
Lindamer LA, Lohr JB, Harris MJ, McAdams LA, Jeste DV. Gender-related clinical differences in older patients with schizophrenia. J Clin Psychiatry. 1999;60:61-7. doi: http://dx.doi.org/10.4088/JCP.v60n0114
Leung A, Chue P. Sex differences in schizophrenia, a review of the literature. Acta Psychiatr Scand Suppl. 2000;401:3-38.doi: http://dx.doi.org/10.1111/j.0065-1591.2000.0ap25.x
Hambrecht M, Maurer K, Hafner H. Gender differences in schizophrenia in three cultures. Results of the WHO collaborative study on psychiatric disability. Soc Psychiatry Psychiatr Epidemiol. 1992;27:117-21.
Naqvi I, Murtaza M, Nazir MR, Naqvi HA. Gender difference in age at onset of schizophrenia: A cross sectional study from Pakistan. J Pak Med Assoc. 2010;60:886-9. PMid:21381632
Segarra R, Ojeda N, Zabala A, García J, Catalan A, Eguiluz JI, et al. Similarities in early course among men and women with a first episode of schizophrenia and schizophreniform disorder. Eur Arch Psychiatry Clin Neurosci. 2011.
Howard R, Castle D, Wessely S, Murray R. A comparative study of 470 cases of early-onset and late-onset schizophrenia. Br J Psychiatry. 1993;163:352-7. doi: http://dx.doi.org/10.1192/bjp.163.3.352
Schultz SK, Ho BC, Andreasen NC. Clinical features characterizing young-onset and intermediate-onset schizophrenia. J Neuropsychiatry Clin Neurosci. 2000;12:502-5. doi: http://dx.doi.org/10.1176/appi.neuropsych.12.4.502
Rapoport JL, Gogtay N. Childhood onset schizophrenia: Support for a progressive neurodevelopmental disorder. Int J Dev Neurosci. 2011;29:251-8. doi: http://dx.doi.org/10.1016/j.ijdevneu.2010.10.003
Chao HM, Kao HT, Porton B. BDNF Val66Met variant and age of onset in schizophrenia. Am J Med Genet B Neuropsychiatr Genet. 2008;147:505-6. doi: http://dx.doi.org/10.1002/ajmg.b.30619
Vahia IV, Palmer BW, Depp C, Fellows I, Golshan S, Kraemer HC, et al. Is late-onset schizophrenia a subtype of schizophrenia? Acta Psychiatr Scand. 2010;122:414-26. doi: http://dx.doi.org/10.1111/j.1600-0447.2010.01552.x
Convert H, Vedie C, Paulin P. Late-onset schizophrenia or chronic delusion. Encephale. 2006;32:957-61. doi: http://dx.doi.org/10.1016/S0013-7006(06)76273-X
Jeste DV, Harless KA, Palmer BW. Chronic late-onset schizophrenia-like psychosis that remitted: Revisiting Newton’s psychosis? Am J Psychiatry 2000;157:444-9. PMid:10698822
Wynn PA, Castle DJ. Late-onset schizophrenia: Epidemiology, diagnosis, management and outcomes. Drugs Aging. 1999;15:81-9. PMid:10495068
Brodaty H, Sachdev P, Koschera A, Monk D, Cullen B. Long-term outcome of late-onset schizophrenia: 5-year follow-up study. Br J Psychiatry. 2003;183:213-9. doi: http://dx.doi.org/10.1192/bjp.183.3.213
Palmer BW, Bondi MW, Twamley EW, Thal L, Golshan S, Jeste DV. Are late-onset schizophrenia spectrum disorders neurodegenerative conditions? Annual rates of change on two dementia measures. J Neuropsychiatry Clin Neurosci. 2003;15:45-52. doi: http://dx.doi.org/10.1176/appi.neuropsych.15.1.45
Lagodka A, Robert P. Is late-onset schizophrenia related to neurodegenerative processes? A review of literature. Encephale. 2009;35:386-93. doi: http://dx.doi.org/10.1016/j.encep.2008.06.008
Hafner H. Gender differences in schizophrenia. Psychoneuroendocrinology. 2003;28(Suppl.2):17-54. doi: http://dx.doi.org/10.1016/S0306-4530(02)00125-7
Benes FM, Turtle M, Khan Y, Farol P. Myelination of a key relay zone in the hippocampal formation occurs in the human brain during childhood, adolescence, and adulthood. Arch Gen Psychiatry. 1994;51:477-84. doi: http://dx.doi.org/10.1001/archpsyc.1994.03950060041004
Lalloo R, Sheiham A. Risk factors for childhood major and minor head and other injuries in a nationally representative sample. Injury. 2003;34:261-6. doi: http://dx.doi.org/10.1016/S0020-1383(02)00277-2
Jablensky A, Cole SW. Is the earlier age at onset of schizophrenia in males a confounded finding? Results from a crosscultural investigation. Br J Psychiatry. 1997;170:234-40. doi: http://dx.doi.org/10.1192/bjp.170.3.234
Estrada G, Fatjo-Vilas M, Muñoz MJ, Pulido G, Minano MJ, Toledo E, et al. Cannabis use and age at onset of psychosis: Further evidence of interaction with COMT Val158Met polymorphism. Acta Psychiatr Scand. 2011;123:485-92. doi: http://dx.doi.org/10.1111/j.1600-0447.2010.01665.x
Salvatore P, Baldessarini RJ, Tohen M, Khalsa HM, Sánchez-Toledo JP, Zarate CA Jr, et al. McLean-Harvard International First-Episode Project: Two-year stability of DSM-IV diagnoses in 500 first-episode psychotic disorder patients. J Clin Psychiatry. 2009;70:458-66. doi: http://dx.doi.org/10.4088/JCP.08m04227
Werry JS, McClellan JM. Predicting outcome in child and adolescent (early onset) schizophrenia and bipolar disorder. J Am Acad Child Adolesc Psychiatry. 1992;31:147-50. doi: http://dx.doi.org/10.1097/00004583-199201000-00022
Scott DW. Multivariate density estimation: Theory, practice, and visualization. New York: Wiley; 1992. doi: http://dx.doi.org/10.1002/9780470316849
Leisch F. FlexMix: A general framework for finite mixture models and latent class regression in R. Journal of Statistical Software. 2004;11(8). Fecha de consulta: 24 de noviembre de 2011. Disponible en: http://www.jstatsoft.org/v11/i08/.
Kraepelin E, Quen JM. Psychiatry: A textbook for students and physicians. Canton, MA: Science History Publications/USA; 1990.
Suvisaari JM, Haukka J, Tanskanen A, Lonnqvist JK. Age at onset and outcome in schizophrenia are related to the degree of familial loading. Br J Psychiatry. 1998;173:494-500. doi: http://dx.doi.org/10.1192/bjp.173.6.494
Haukka J, Suvisaari J, Lonnqvist J. Increasing age does not decrease risk of schizophrenia up to age 40. Schizophr Res. 2003;61:105-10. doi: http://dx.doi.org/10.1016/S0920-9964(02)00233-5
Some similar items:
- Julián A. Fernández-Niño, Claudia I. Astudillo-García, Laura María Segura, Natalia Gómez, Ángela Skantria Salazar, Juan Hember Tabares, Cristian Andrés Restrepo, Miguel Ángel Ruiz, Myriam Consuelo López, Patricia Reyes, Profiles of intestinal polyparasitism in a community of the Colombian Amazon region , Biomedica: Vol. 37 No. 3 (2017)
- Juanita Camacho, Diana Moscote, Yoseth J. Ariza , HIV in women over 50 years: An analysis of administrative data in the departments of the Colombian Pacific region (2014-2018) , Biomedica: Vol. 41 No. Sp. 2 (2021): Octubre, Infecciones bacterianas y virales
- Stefano Tassinari, Samuel Martínez-Vernaza, Nicole Erazo-Morera, María Camila Pinzón-Arciniegas, Gloria Gracia, Ignacio Zarante, Epidemiology of congenital heart diseases in Bogotá, Colombia, from 2001 to 2014: Improved surveillance or increased prevalence? , Biomedica: Vol. 38 No. Sup.1 (2018): Suplemento 1, Enfermedades crónicas
- Jorge Arturo Martínez, Walter Amaya, Horacio Alfredo Campillo, Adalberto Campo, Luis Alfonso Díaz, Social factors associated with the daily cigarette smoking among middle-school student adolescents in Bucaramanga, Colombia. , Biomedica: Vol. 25 No. 4 (2005)
- Diana Marcela Echeverry, Juan Miguel Rengifo, Jhon Carlos Castaño, Germán Alberto Téllez, María Mercedes González, Prevalence of Mammomonogamus laryngeus (Strongylida: Syngamidae) nematodes in a bovine slaughterhouse , Biomedica: Vol. 31 No. 3 (2011)
- Luz Elena Velásquez, Catalina Gómez, Erika Valencia, Laura Salazar, Eudoro Casas, Paragonimosis in the peri-urban zone of Medellín, Antioquia , Biomedica: Vol. 28 No. 3 (2008)
- Ligia Inés Moncada, Sandra Milena Rios, Julián Alfredo Fernández, Fabio Rivas, María Luz Sáenz, Pediculosis prevalence and associated risk factors in a nursery school, Bogotá, Colombia , Biomedica: Vol. 28 No. 2 (2008)
- Francisca Monsalve, Leonor Chacín Bonilla, Ricardo José Atencio, Leticia Denys Porto, Luciana Ana Costa León, Jesús Enrique Estévez, Diana Estela Callejas Valero, Low prevalence of hepatitis C virus infection in a prisoner population from Maracaibo, Venezuela , Biomedica: Vol. 29 No. 4 (2009)
- Juan P. Gómez, Juan C. Quintana, Patricia Arbeláez, Jorge Fernández, Juan F. Silva, Jacqueline Barona, Juan C. Gutiérrez, Abel Díaz, Rafael Otero, Tityus asthenes scorpion stings: epidemiological, clinical and toxicological aspects , Biomedica: Vol. 30 No. 1 (2010)
- Juan Gabriel Piñeros, Malaria and social health determinants: a new heuristic framework from the perspective of Latin American social medicine , Biomedica: Vol. 30 No. 2 (2010)
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
