Age of onset symptoms and gender in schizophrenic spectrum disorders

Ricardo Sánchez, Gerardo Téllez, Luis Eduardo Jaramillo, .

Keywords: esquizofrenia y trastornos con características psicóticas/epidemiología, edad de inicio, distribución por edad y sexo, incidencia, prevalencia, resultado del tratamiento, modelos estadísticos

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

Download data is not yet available.
  • Ricardo Sánchez Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia

    Departamento de Psiquiatría, Universidad Nacional de Colombia.

    Grupo de Investigaciones Clínicas, Instituto Nacional de Cancerología.

  • Gerardo Téllez Clínica Nuestra Señora de la Paz, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
  • Luis Eduardo Jaramillo Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia
    Departamento de Psiquiatría, Universidad Nacional de Colombia

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

How to Cite
1.
Sánchez R, Téllez G, Jaramillo LE. Age of onset symptoms and gender in schizophrenic spectrum disorders. biomedica [Internet]. 2012 Jun. 30 [cited 2024 May 19];32(2):206-13. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/423
Published
2012-06-30
Section
Original articles

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code