Women, aging, and schizophrenia

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the lifespan. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women then men, and women are over-represented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed to the problems of older women with schizophrenia.