Title: Gender Difference in Symptom Presentation in Schizophrenia- A Cross Sectional Study
Authors: Shivendra Kumar, Sanjay Kumar Munda, CRJ Khess
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.139
Abstract
Introduction: Males and females are different both biologically and physiologically. Also social roles, norms, and traditions are different in males and females. So it may be presumed that they may also differ in symptom presentation during illness. Also culture may have important contribution when it comes to gender, both in non-diseased and diseased state as many psychosocial hypotheses have been proposed in causation of mental illness. Schizophrenia is regarded as most severe mental illness. Many prior studies have established that males have more negative symptoms and females more prominent positive symptoms. But this difference needs to be examined in different settings to have more comprehensive assessment and treatment for better outcome.
Materials and Methods: 25 male and 25 female patients of schizophrenia taken by purposive sampling and cross sectional assessment of baseline symptoms were done by PANSS. Analysis of the sample done by statistical methods to identify difference in symptomatology.
Results: PANSS negative symptom score was higher in males (21.96±6.99) than females (17.20±5.21) and it was significant (p=.01). PANSS positive symptom score was higher in female (27.60±4.85) than male (24.92±6.23) patients of schizophrenia. The association was not significant in positive symptoms (p=.09).
Conclusions: At the level of baseline psychopathology, positive symptoms were more prominent in females and negative symptoms in males.
Keywords: Schizophrenia, Negative and positive symptoms.
References
- Hughlings Jackson J: Selected Writings. London, Hodder and Stoughton 1931–1932.
- Andreasen NC. The scale for the assessment of positive symptoms (SAPS). Iowa City: University of Iowa 1984.
- Preston NJ, Orr KG, Date R, Nolan L, Castle DJ. Gender differences in premorbid adjustment of patients with first episode psychosis. Schizophrenia Research 2002; 55:285–290.
- Moriarty PJ, Lieber D, Bennett A, White L, Parrella M, Harvey PD, et al. Gender differences in poor outcome patients with lifelong schizophrenia. Schizophrenia Bulletin 2001; 27:103–113.
- Häfner H. Gender differences in schizophrenia. Psychoneuroendocrinology 2003; 28:17–54.
- Thorup A, Petersen L, Jeppesen P, Ohlenschloeger J, Christensen T, Krarup G, et al. Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study. Journal of Nervous and Mental Disease 2007;195:396–405.
- Edgerton, R.B., and Cohen, A. Culture and schizophrenia: The DOSMD challenge. British Journal of Psychiatry 1994;164:222-231.
- Rietschel L, Lambert M, Karow A, Zink M, Muller H, Heinz A, et al. Clinical high risk for psychosis: gender differences in symptoms and social functioning. Early Interv Psychiatry 2015;11:306-313.
- Ring N, Tantam D, Montague L, Newby D, Black D, Morris J. Gender differences in the incidence of definite schizophrenia and atypical psychosis—focus on negative symptoms of schizophrenia. Acta Psychiatrica Scandenavica 1991;84:489–496.
- Nedopil N, Pflieger R, Ruther E. The prediction of acute response, remission and general outcome of neuroleptic treatment in acute schizophrenic patients. Pharmacopsychiatria 1983;16:201–205.
- Addington J, Addington D. Premorbid functioning, cognitive functioning, symptoms and outcome in schizophrenia. Journal of Psychiatry and Neuroscience 1993;18:18–23.
- E. Maglione, S. E. Thomas, and D. V. Jeste, “Late-onset schizophrenia: do recent studies support categorizing los as a subtype of schizophrenia?” Current Opinion in Psychiatry 2014;27:173–178.
- The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. World Health Organization, Washington, DC;1992.
- Kay SR, Fiszbein A, Opler LA. The Positive and Negative Syndrome Scale for Schizophrenia (PANSS). Schizophrenia Bulletin 1987;13:261-269.
- Grover S, Sarkar S. Antipsychotic Trials in Schizophrenia from India: A Systematic Review and Meta-analysis. Indian J Pharm Sci 2015;77:771-779.
- Shtasel DL, Gur RE, Gallacher F, Heimberg C, Gur RC. Gender differences in the clinical expression of schizophrenia. Schizophrenia Research 1992;7:225– 231.
- Pinals DA, Malhotra AK, Missar CD, Pickar D, Breier A. Lack of gender differences in neuroleptic response in patients with schizophrenia. Schizophrenia Research 1996;22:215-222.
- Emsley RA, Oosthuizen PP, Joubert AF, Roberts MC, Stein DJ. Depressive and anxiety symptoms in patients with schizophrenia and schizophreniform disorder. Journal of Clinical Psychiatry 1999;60:747–750.
- Thara R, Kamath S. Women and schizophrenia. Indian J Psychiatry 2015;57(2):S246-251.