AGE AT ONSET AND GENDER OF SCHIZOPHRENIC-PATIENTS IN RELATION TO NEUROLEPTIC RESISTANCE

Objective: The age at onset of schizophrenia for males has usually but not always been reported to be less than that for females. Early onse t has also been associated with poor response to neuroleptic treatment and worse long-term outcome. The authors compared age at onset in neu roleptic-resistant and -responsive schizophrenic patients to determine whether the gender difference in age at onset is related to response to neuroleptic treatment. Method: The subjects were 322 patients with schizophrenia or schizoaffective disorder who were consecutively admit ted to a university hospital-based research program. Results: Analysis of variance showed significant relationships between age at onset and both gender and longterm responsivity to neuroleptic drugs. The mean ages at onset in the neuroleptic-responsive men (mean=21.2 years, SD=6 .1, N=75), neuroleptic-resistant men (mean=19.4 years, SD=4.7, N=119), and neuroleptic-resistant women (mean=20.1 years, SD=6.3, N=77) were fairly similar, whereas that of the neuroleptic-responsive women (mean =24.2 years, SD=8.7, N=51) was significantly greater than for all othe r groups. A simple effects model indicated that male and female neurol eptic-resistant patients did not differ significantly in mean age at o nset, whereas male and female neuroleptic-responsive patients did. The effect of gender and neuroleptic responsivity on age at onset was rel ated to schizophrenic subtype. Conclusions: These results confirm prev ious data indicating neuroleptic resistance is associated with early o nset. The finding that the difference in age at onset between males an d females is smaller in neuroleptic-resistant patients than in neurole ptic-responsive patients suggests that neuroleptic-resistant patients differ premorbidly as well as after onset of illness.