Influence of gender in schizophrenia as related to other psychopathological syndromes

The evidence indicating that the forms of schizophrenia in men and women represent different morbid states is reviewed. Age of onset and gender are considered to be of fundamental importance in determining the different symptomatological and evolutionary features of the syndrome in the two sexes. Early-onset forms in males are associated with chronicity, absence of familial predisposition for psychosis, and the presence of structural cerebral pathology specifically involving the dominant hemisphere. Later onset forms in females are characterized by more florid symptoms, more affective features, more familial psychosis, and more favorable outcome with no or less pronounced structural cerebral involvement. It is argued that these differential characteristics derive from the differential hemispheric organization of the male and female brain--which also determines the male susceptibility to other psychopathological syndromes such as psychopathy and sexual deviations as well as the excess in women of schizoaffective states, affective disorders, and late-onset schizophrenia.