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Am J Psychiatry 1996; 153:799-805
Copyright © 1996 by American Psychiatric Association
Sex differences in neuroanatomical and clinical correlations in schizophrenia
PE Cowell, DJ Kostianovsky, RC Gur, BI Turetsky and RE Gur
Department of Psychiatry, University of Pennsylvania, Philadelphia 19104, USA.
OBJECTIVE: The purpose of this study was to investigate sex differences in
relationships between brain and behavior in schizophrenia. METHOD: Frontal
lobe, temporal lobe, and whole brain volumes were obtained from magnetic
resonance images of 91 patients with schizophrenia (54 men and 37 women)
and 114 healthy comparison subjects (62 men and 52 women). Four independent
symptom scales, based on the following symptom clusters, were derived from
clinical data: negative, disorganization, Schneiderian
hallucinations-delusions, and suspicion-hostility. Regression analyses
incorporating the four clinical scales and neuroanatomical volumes were
performed to investigate possible interactions between brain region and
sex. RESULTS: Significant interactive effects of sex and frontal lobe
volume were found in regression analyses of the disorganization and
suspicion-hostility symptom scales. In men, higher frontal lobe volume was
associated with milder severity of disorganization but was not correlated
with severity of suspicion-hostility. In women, higher frontal lobe volume
was associated with more severe disorganization as well as more severe
suspicion-hostility. No associations were found between brain volume and
severity of negative or Schneiderian symptoms. CONCLUSIONS: Differences
between male and female patients were observed in the relationships between
frontal lobe volume and two of the four clinical dimensions examined. These
findings suggest that aspects of the neuropathological basis for some
symptoms of schizophrenia may be sexually dimorphic.
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