S. Szymanski et al., GENDER DIFFERENCES IN ONSET OF ILLNESS, TREATMENT RESPONSE, COURSE, AND BIOLOGIC INDEXES IN FIRST-EPISODE SCHIZOPHRENIC-PATIENTS, The American journal of psychiatry, 152(5), 1995, pp. 698-703
Objective: Gender differences in onset of illness, response to treatme
nt, course, and biologic measures have been consistently reported in p
atients with chronic schizophrenia. Patients with first-episode schizo
phrenia were examined to determine whether gender differences also occ
ur in these patients. Method: Fifty-four neuroleptic-naive schizophren
ic patients (29 men and 25 women) were studied beginning in an initial
stage of the first hospitalization for psychosis while undergoing tre
atment with a standardized medication regimen. Before antipsychotic dr
ug treatment and during 1 year of follow-up each patient was rated on
the Schedule for Affective Disorders and Schizophrenia-Change Version
(psychosis and disorganization items), Scale for the Assessment of Neg
ative Symptoms, Clinical Global Impression, modified Simpson Tardive D
yskinesia Scale, and Simpson-Angus Rating Scale for extrapyramidal sid
e effects. Methylphenidate challenge testing was done at study entry.
Plasma neuroleptic, homovanillic acid (HVA), and prolactin levels were
determined weekly for the first 6 weeks. Results: The female schizoph
renic patients had a later onset and better treatment response than th
e men. Plasma HVA levels at baseline and week 1 and changes in prolact
in levels from baseline to weeks 1 through 6 were greater among the wo
men. Conclusions: Gender differences in onset and degree of treatment
response in first-episode schizophrenic patients are similar to those
of chronic patients and are apparent at early stages of the illness. T
he greater pharmacologic responsivity of the female patients, as indic
ated by the neuroendocrine results, is consistent with the gender diff
erence in degree of symptom improvement with medication.