Sex differences in schizophrenia, bipolar disorder, and post‐traumatic stress disorder: Are gonadal hormones the link?

British Journal of Pharmacology, Год журнала: 2019, Номер 176(21), С. 4119 - 4135

Опубликована: Янв. 18, 2019

In this review, we describe the sex differences in prevalence, onset, symptom profiles, and disease outcome that are evident schizophrenia, bipolar disorder, post-traumatic stress disorder. Women with schizophrenia tend to exhibit less impairment than men. By contrast, women disorder more affected The most likely candidates explain these gonadal hormones. This review details clinical evidence oestradiol progesterone dysregulated psychiatric disorders. Notably, existing data on oestradiol, a lesser extent, progesterone, suggest low levels of hormones may increase risk development worsen severity. We argue future studies require inclusive, considered analysis steroid intricacies interactions between them, methodological rigour applied, enhance our understanding roles LINKED ARTICLES: article is part themed section Importance Sex Differences Pharmacology Research. To view other articles visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.

Язык: Английский

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The clinical course of schizophrenia in women and men—a nation-wide cohort study

Schizophrenia, Год журнала: 2020, Номер 6(1)

Опубликована: Май 1, 2020

Abstract Gender differences in schizophrenia have been reported different aspect of the course disease and may urge special clinical interventions for female patients. Current literature provides insufficient information to design guidelines treating women with schizophrenia. We aim quantify men on premorbid hospitalizations prescription drugs, age at diagnosis, pharmacological treatment, comorbidity, number re-hospitalizations, mortality. Our nationwide cohort study included all patients admitted first time hospital during 2000–2014 or schizo-affective disorder Finland. were compared logistic regression, by calculating incidence rates, mortality was assessed Cox proportional hazard model. 7142 9006 schizophrenia/schizo-affective found that both (71%) (70%) had often hospitalized another psychiatric 5 years before diagnosis. In women, last hospitalization diagnosis mood disorders (62%, OR 2.56, 95% CI 2.28–2.87). Men diagnosed earlier (mean 34.4 [SD12.6] vs. 38.2 [SD 13.8]) peak around 22, while declining only slowly between 18 65. During ten follow-up, 69.5% genders needed least one re-hospitalization, slightly more women. Women less prescribed clozapine long-acting antipsychotics. Mortality lower (HR = 0.54, 0.50–0.60), fewer suicide cardiovascular deaths, but cancer deaths. These results suggest a diagnostic delay which might be shortened screening aged 20–65 participating affective programs. As is not clinicians should take care undertreat

Язык: Английский

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Changes in Incident Schizophrenia Diagnoses Associated With Cannabis Use Disorder After Cannabis Legalization

JAMA Network Open, Год журнала: 2025, Номер 8(2), С. e2457868 - e2457868

Опубликована: Фев. 4, 2025

Importance Despite public health concerns that cannabis legalization may increase the number of cases schizophrenia caused by cannabis, there is limited evidence on this topic. Objective To examine changes in population-attributable risk fraction (PARF) for use disorder (CUD) associated with after liberalization medical and nonmedical Canada. Design, Setting, Participants This population-based cohort study was conducted Ontario, Canada, from January 1, 2006, to December 31, 2022, among 13 588 681 people aged 14 65 years without a history schizophrenia. Exposures Diagnosis CUD emergency department or hospital setting ( International Statistical Classification Diseases Related Health Problems, Tenth Revision, Canada [ ICD-10-CA ] codes F12x T40.7). Main Outcome Measures Changes PARF F20x F25x Diagnostic Manual Mental Disorders [Fourth Edition] DSM-IV code 295x) over 3 policy periods: prelegalization (January 2006 November 2015), (December 2015 September 2018), (October 2018 2022). A secondary outcome diagnosis psychosis not otherwise specified (NOS) F29x 298x). Segmented linear regression used 2018. Results The included individuals (mean [SD] age, 39.3 [16.1] years; 6 804 906 males [50.1%]), whom 118 650 (0.9%) had CUD. total 91 106 (0.7%) developed (80 523 470 031 [0.6%] general population vs 10 583 [8.9%] CUD). almost tripled 3.7% (95% CI, 2.7%-4.7%) during period 10.3% 8.9%-11.7%) period. postlegalization ranged 18.9% 16.8%-21.0%) 19 24 1.8% 1.1%-2.6%) females 45 years. annual incidence stable time, while NOS increased 30.0 55.1 per 100 000 (83.7%) relative steadily no accelerations changes, increases accelerated liberalization. Conclusions Relevance In proportion incident substantial policy. Ongoing research indicated understand long-term associations prevalence psychotic disorders.

Язык: Английский

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Non-alcoholic fatty liver disease (NAFLD) as a neglected metabolic companion of psychiatric disorders: common pathways and future approaches

BMC Medicine, Год журнала: 2020, Номер 18(1)

Опубликована: Окт. 1, 2020

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic steatosis in over 5% of the parenchyma absence excessive alcohol consumption. It more prevalent patients with diverse mental disorders, being part comorbidity driving loss life expectancy and quality life, yet remains a neglected entity. NAFLD can progress to non-alcoholic steatohepatitis (NASH) increases risk for cirrhosis carcinoma. Both disorders share pathophysiological pathways, also present complex, bidirectional relationship metabolic syndrome (MetS) related cardiometabolic diseases. Main text This review compares demographic data on NASH among global population psychiatric population, finding differences that suggest higher incidence this latter. analyzes link between looking into common such as metabolic, genetic, lifestyle factors. Finally, possible treatments, tailored approaches, future research directions are suggested. Conclusion complex system non-communicable somatic pathogenesis, based shared environmental risks, mediated dysregulation inflammation, oxidative stress mitochondrial function. The recognition required inform clinical practice develop novel interventions prevent treat these interacting disorders.

Язык: Английский

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Estrogens in schizophrenia: progress, current challenges and opportunities

Current Opinion in Psychiatry, Год журнала: 2021, Номер 34(3), С. 228 - 237

Опубликована: Фев. 4, 2021

Schizophrenia is a heterogeneous psychiatric disorder with different, but not necessarily milder clinical presentation in women as compared to men. These sex differences have largely been attributed the protective role of estrogens. This article reviews current state estrogen research schizophrenia.

Язык: Английский

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Gender Differences in Clinical and Psychosocial Features Among Persons With Schizophrenia: A Mini Review

Frontiers in Psychiatry, Год журнала: 2021, Номер 12

Опубликована: Дек. 22, 2021

An extensive literature regarding gender differences relevant to several aspects of schizophrenia is nowadays available. It includes some robust findings as well inconsistencies. In the present review, we summarize on in clinical and social outcome their determinants, focusing variables, while biological factors which may have an impact disorder were not included herewith. Consistent include, male with respect female patients, earlier age illness onset limited early- middle-onset schizophrenia, a worse premorbid functioning, greater severity negative symptoms, lower affective symptoms higher rate comorbid alcohol/substance abuse. Discrepant been reported positive non-social cognition, functional rates recovery. fact, despite overall finding more severe picture males, this does seem translate into outcome. From recent emerges that, although are consistent, there still need clarification by means further studies taking account methodological issues.

Язык: Английский

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Sex differences in the blood–brain barrier: Implications for mental health

Frontiers in Neuroendocrinology, Год журнала: 2022, Номер 65, С. 100989 - 100989

Опубликована: Март 8, 2022

Prevalence of mental disorders, including major depressive disorder (MDD), bipolar (BD) and schizophrenia (SZ) are increasing at alarming rates in our societies. Growing evidence points toward sex differences these conditions, high treatment resistance support the need to consider novel biological mechanisms outside neuronal function gain mechanistic insights that could lead innovative therapies. Blood-brain barrier alterations have been reported MDD, BD SZ. Here, we provide an overview sex-specific immune, endocrine, vascular transcriptional-mediated changes affect neurovascular integrity possibly contribute pathogenesis disorders. We also identify pitfalls current literature highlight promising biomarkers. Better understanding how adaptations can health status is essential not only context SZ but cardiovascular diseases stroke which associated with higher prevalence conditions.

Язык: Английский

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On the proportion of patients who experience a prodrome prior to psychosis onset: A systematic review and meta-analysis

Molecular Psychiatry, Год журнала: 2024, Номер 29(5), С. 1361 - 1381

Опубликована: Фев. 2, 2024

Язык: Английский

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Sex differences in antipsychotic efficacy and side effects in schizophrenia spectrum disorder: results from the BeSt InTro study

Schizophrenia, Год журнала: 2021, Номер 7(1)

Опубликована: Авг. 18, 2021

Abstract Current guidelines for patients with schizophrenia spectrum disease do not take sex differences into account, which may result in inappropriate sex-specific treatment. In the BeSt InTro study, a total of 144 (93 men and 51 women) diagnosis ongoing psychosis were included randomized to amisulpride, aripiprazole, or olanzapine flexible dose. This trial is registered ClinicalTrials.gov (NCT01446328). Primary outcomes dose, dose-corrected serum levels, efficacy, tolerability. Dosing was higher than women aripiprazole group ( p = 0.025) and, at trend level, 0.056). Dose-corrected levels 71.9% amisulpride 0.019) 55.8% 0.049). group, had faster decrease psychotic symptoms 0.003). Moreover, more effective other medications but women. Prolactin men, especially < 0.001). Also, BMI increase on compared two antipsychotics We conclude that clinicians should be aware risks overdosing women, aripiprazole. Amisulpride highly showed severe side effects thus drug first choice. Our study shows taken account future studies antipsychotics. Future research warranted evaluate these preliminary results.

Язык: Английский

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A systematic review of longitudinal studies of suicidal thoughts and behaviors in first-episode psychosis: course and associated factors

Social Psychiatry and Psychiatric Epidemiology, Год журнала: 2021, Номер 56(12), С. 2117 - 2154

Опубликована: Авг. 25, 2021

Язык: Английский

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