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Am J Psychiatry 1995; 152:883-888
Copyright © 1995 by American Psychiatric Association
Lack of sex differences in the neuropsychological performance of patients with schizophrenia
TE Goldberg, JM Gold, EF Torrey and DR Weinberger
Clinical Brain Disorders Branch, NIMH, Washington, D.C., USA.
OBJECTIVE: While a number of studies have suggested that women with
schizophrenia have a less severe form of the disorder than men, the issue
has been examined with neuropsychological measures only infrequently.
METHOD: The authors compared neuropsychological test performances of men
and women from four independent schizophrenic cohorts: two groups of
inpatients with chronic courses at a research hospital (N = 128 and N =
63), one group of consecutive admissions to a private psychiatric hospital
(N = 57), and one group of schizophrenic twins from discordant monozygotic
pairs (N = 20). Nearly 100 comparisons of neuropsychological test
performances were made between men and women. RESULTS: Not one comparison
significantly favored women, and few were even significantly different
between the sexes. CONCLUSIONS: It cannot be ruled out that the
disproportionate number of men in the chronic cohorts may have reflected
either more frequent intellectual deterioration in men or a bias toward
more severely impaired women. Yet, men and women in all groups performed
similarly, including the groups in which the sex ratios were nearly equal
and were not skewed toward chronicity. These results provide little support
for the hypothesis that gender is associated with a unique pathogenesis of
schizophrenia or is a marker for a distinct subtype of schizophrenia, at
least to the extent that cognitive impairment is a primary manifestation of
the underlying disease process. However, given the lack of female patients
with later ages at onset and more affective symptoms, the results in this
study should be considered relevant only for chronic patients with onset of
schizophrenia before age 30.
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