The clinical course of schizophrenia in women and men—a nation-wide cohort study
Autor: | Anouk van Mourik, Iris E. C. Sommer, Heidi Taipale, Jari Tiihonen, Antti Tanskanen |
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Přispěvatelé: | Clinical Cognitive Neuropsychiatry Research Program (CCNP), Movement Disorder (MD) |
Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Pediatrics
medicine.medical_specialty lcsh:RC435-571 Psychological intervention Article 03 medical and health sciences 0302 clinical medicine AGE 5. Gender equality lcsh:Psychiatry medicine 030212 general & internal medicine Clozapine RISK GENDER-DIFFERENCES business.industry Proportional hazards model Incidence (epidemiology) medicine.disease Psychosis Comorbidity 3. Good health 030227 psychiatry LIFE Psychiatry and Mental health Mood disorders Schizophrenia DEPRESSIVE SYMPTOMS ONSET SEX business Cohort study medicine.drug |
Zdroj: | npj Schizophrenia, Vol 6, Iss 1, Pp 1-7 (2020) NPJ Schizophrenia NPJ Schizophrenia, 6(1):12. SPRINGERNATURE |
ISSN: | 2334-265X |
Popis: | Gender differences in schizophrenia have been reported in different aspect of the course of disease and may urge special clinical interventions for female patients. Current literature provides insufficient information to design guidelines for treating women with schizophrenia. We aim to quantify the clinical course of schizophrenia in men and women on premorbid hospitalizations and prescription drugs, age at diagnosis, pharmacological treatment, comorbidity, number of re-hospitalizations, and mortality. Our nationwide cohort study included all patients admitted for the first time to hospital during 2000–2014 for schizophrenia or schizo-affective disorder in Finland. Gender differences were compared with logistic regression, by calculating incidence rates, and mortality was assessed with Cox proportional hazard model. We included 7142 women and 9006 men with schizophrenia/schizo-affective disorder and found that both women (71%) and men (70%) had often been hospitalized for another psychiatric disorder in the 5 years before diagnosis. In women, the last psychiatric hospitalization before schizophrenia/schizo-affective diagnosis was often for mood disorders (62%, OR 2.56, 95% CI 2.28–2.87). Men were diagnosed earlier (mean 34.4 [SD12.6] vs. 38.2 [SD 13.8]) with peak incidence around 22, while incidence in women declining only slowly between age 18 and 65. During ten years follow-up, 69.5% of both genders needed at least one re-hospitalization, with slightly more hospitalizations in women. Women were less often prescribed clozapine or long-acting antipsychotics. Mortality was lower in women (HR = 0.54, 95% CI 0.50–0.60), with fewer suicide and cardiovascular deaths, but more cancer deaths. These results suggest a diagnostic delay for women, which might be shortened by screening women aged 20–65 participating in affective disorder programs. As number of hospitalizations is not lower for women, clinicians should take care not to undertreat women with schizophrenia. |
Databáze: | OpenAIRE |
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