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Sex differences in psychosis: normal or pathological?

Janneke Spauwen1, Lydia Krabbendam, Roselind Lieb

  • 1Department of Psychiatry and Neuropsychology, Maastricht University, European Graduate School of Neuroscience, PO Box 616 (DRT 10), 6200 MD Maastricht, The Netherlands.

Schizophrenia Research
|May 27, 2003
PubMed
Summary

Males aged 17-21 show higher rates of psychosis-like experiences than females. This difference diminishes in older adolescents (22-28), suggesting developmental changes influence psychosis expression, the extreme of which is schizophrenia.

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Area of Science:

  • Psychiatry
  • Developmental Psychology
  • Epidemiology

Background:

  • Schizophrenia typically emerges during adolescence, with earlier onset observed in males compared to females.
  • Understanding age-related sex differences in subclinical psychosis-like experiences is crucial for interpreting schizophrenia's epidemiology.
  • Investigating psychosis-like experiences provides insight into the developmental trajectory of schizophrenia.

Purpose of the Study:

  • To examine age- and sex-specific differences in subclinical psychosis-like experiences among adolescents and young adults.
  • To determine if observed sex differences in schizophrenia onset align with differences in subclinical psychosis expression.
  • To explore the role of developmental maturation in sex differences in psychosis risk.

Main Methods:

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  • A population sample of 2548 adolescents and young adults aged 17-28 was assessed.
  • The Munich-Composite International Diagnostic Interview's core psychosis sections (delusions and hallucinations) were utilized.
  • Data analysis focused on identifying sex differences in psychosis-like experiences across different age bands.

Main Results:

  • Males in the younger age group (17-21 years) exhibited a significantly higher risk of subclinical psychotic experiences.
  • In the older age group (22-28 years), the risk of subclinical psychotic experiences was similar between males and females.
  • These findings indicate a developmental shift in the expression of psychosis-like experiences concerning sex differences.

Conclusions:

  • Normal adolescent maturation processes, characterized by differential onset ages in males and females, appear to influence the expression of psychosis.
  • The observed age-related sex differences in subclinical psychosis-like experiences may underlie the epidemiological pattern of schizophrenia's onset.
  • These findings support the hypothesis that developmental factors play a significant role in the etiology of schizophrenia.