Gender Differences in Schizophrenia and Psychosis
Summary
The onset, trajectory and expression of schizophrenia and psychotic disorders differ markedly between men and women. Men tend to present earlier, with a single incidence peak in late adolescence and more pronounced negative symptoms, poorer social and cognitive premorbid adjustment and a higher rate of comorbid substance use. Women show a later and often bimodal age distribution, more affective and positive features, and comparatively better premorbid functioning. Hormonal factors such as oestrogen’s modulatory effects on dopamine receptors contribute to sex‐specific variations in symptom severity, treatment response and adverse effects. These gender differences have important implications for diagnosis, personalised antipsychotic dosing, psychosocial interventions and long‐term functional recovery worldwide.
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Gender Differences in Schizophrenia and Psychosis publication trend
The graph below shows the total number of articles in gender differences in schizophrenia and psychosis across all publications each year (not limited to Nature Index journals).
Technical terms
Premorbid adjustment: The level of social, academic or occupational functioning prior to onset of psychotic symptoms.
First-episode psychosis: The initial manifestation of psychotic symptoms such as delusions or hallucinations in an individual.
Negative symptoms: Deficits in normal emotional and social functions, including apathy, reduced speech and diminished motivation.
Antipsychotic: A class of medications that block dopamine receptors to reduce psychotic symptoms.
Insight: Awareness and understanding by a patient of their own mental health condition.
References
- The relationship between sex and functional outcome in first-episode schizophrenia: the role of premorbid adjustment and insight. Psychological Medicine (2023).
- Sex matters: Differences in prodromes, clinical and neuropsychological features in individuals with a first episode mania or psychosis. Journal of Affective Disorders (2024).
- Sex differences in autonomic adverse effects related to antipsychotic treatment and associated hormone profiles. Schizophrenia (2024).
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