Schizophrenia: Men vs. Women

Is Schizophrenia More Common In Males Or Females?

Ultimately, research is skewed when it comes to the prevalence of schizophrenia in men and women. However, there are gender differences in the adjustment and treatment of the disorder, possibly because women presented a higher age of onset than men, which allows them to adjust better to the requirements of the community.¹ Below is more on the differences of schizophrenia in women and men broken down into age of onset, symptoms, and functioning.

Age of Onset

The age of schizophrenia onset in men is 18 to 25, while in women, the mean age of onset is 25 to 35.¹ Schizophrenia symptoms also seem to peak twice in women. The first typically appears after the first menstrual period (menarche), and the second once they are over 40. The major prevalence of women once they are over 40 years old could be explained by the reduction of estrogen after menopause.¹

Symptoms

Multiple studies have identified gender-based distinctions in the severity of negative symptoms in individuals with schizophrenia. These investigations have shown that, in males, negative symptoms tend to be more pronounced. Additionally, a study involving 276 individuals diagnosed with schizophrenia found that men exhibited higher scores in disorganization and negative symptoms. A substantial patient cohort with psychosis revealed a greater prevalence of depressive symptoms among women, while negative symptoms were less prevalent in this group. Prior research has consistently reported a higher incidence of depressive and anxiety symptoms in women.^{1, 2}

Premorbid Functioning

Most studies have found differences in schizophrenia in men vs. women when it comes to premorbid functioning, which is an individual's level of cognitive and memory functioning before the onset of injury or illness. Specifically, premorbid functioning of schizophrenia was found to be worse in men than in women. One study found that women had better social functioning and marital adjustment. However, in a sample of 113 patients, females, and those with a diagnosis of schizoaffective disorder had better premorbid adjustment academically but not socially.³

Social Functioning

Generally, gender differences in schizophrenia have found better performance in women than in men. One study found that women adapted better to the disorder than men.⁴ In a three-year follow-up study of 86 patients, men were found to have a worse prognosis. Men also scored higher in disability in another study of 239 patients.⁵ However, a long-term study (15 years) failed to find any gender differences in social disability in individuals with schizophrenia.⁶

Ultimately, no clear and recent research indicates whether schizophrenia is more common in men or women. While some gender differences can be found in the way the disorder manifests itself, a precise difference in prevalence or diagnosis is unclear. Regardless of prevalence, a common theme that can be seen across all mental health disorders is the benefits of early intervention and identification.

Therefore, if you suspect that you may have the disorder or that a loved one is exhibiting signs of schizophrenia, get a diagnosis right away. Mental health diagnostic services are offered at our mental health facilities in Massachusetts and Florida to help individuals determine whether they have a mental illness, the nature of their symptoms, and how to best treat them.

Does Schizophrenia Affect Men and Women Equally?

Yes, schizophrenia affects men and women relatively equally in terms of prevalence. However, there are notable differences in how the disorder can manifest and progress in each gender. These distinctions may influence how schizophrenia is perceived and diagnosed.

These differences include:

• Age of onset:
  • Men: Generally, men tend to experience the onset of schizophrenia at a younger age than women. It is more common for the symptoms to manifest during late adolescence or early adulthood in men.
  • Women: Women often develop schizophrenia slightly later, typically in their mid to late twenties. This age difference in onset may be influenced by hormonal and neurobiological factors.
• Symptomatology:
  • Men: Men with schizophrenia frequently exhibit more severe negative symptoms, such as social withdrawal, flattened affect, and reduced motivation. These negative symptoms can impact their ability to function in daily life.
  • Women: Women may experience more affective symptoms, including mood disturbances like depression and anxiety. They may also display fewer negative symptoms. This gender-based difference in symptom presentation can lead to variations in diagnosis and treatment approaches.
• Hormonal influences:
  • Men: Hormonal fluctuations have less pronounced effects on the symptomatology of schizophrenia in men due to their relatively stable hormonal profiles.
  • Women: Hormonal changes, such as those associated with the menstrual cycle, pregnancy, and menopause, can influence the course of schizophrenia in women. Some women with schizophrenia may experience symptom exacerbation or improvement during these hormonal shifts, requiring tailored treatment strategies.
• Diagnostic challenges:
  • Men: The prominence of negative symptoms in men can sometimes lead to delayed diagnosis or misdiagnosis, as these symptoms are less readily recognized than positive symptoms like hallucinations or delusions.
  • Women: The presence of affective symptoms in women may lead to misdiagnosis as mood disorders. This can delay appropriate psychotic disorder treatment.

While the occurrence of schizophrenia is similar, it is imperative to investigate the gender-related differences in symptomatology, age of onset, and the influence of hormonal fluctuations on the expression of this intricate mental disorder.