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Sex and gender differences in schizophrenic psychoses—a critical review


Many sex and gender differences in schizophrenic psychoses have been reported, but few have been soundly replicated. A stable finding is the later age of onset in women compared to men. Gender differences in symptomatology, comorbidity, and neurocognition seem to reflect findings in the general population. There is increasing evidence for estrogens being psychoprotective in women and for hypothalamic–pituitary–gonadal dysfunction in both sexes.

More methodologically sound, longitudinal, multi-domain, interdisciplinary research investigating both sex (biological) and gender (psychosocial) factors is required to better understand the different pathogenesis and etiologies of schizophrenic psychoses in women and men, thereby leading to better tailored treatments and improved outcomes.

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We thank Claudine Pfister, MA, for her help in the preparation of the manuscript.


This research did not receive any specific grants or funding.

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Correspondence to Anita Riecher-Rössler.

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Riecher-Rössler, A., Butler, S. & Kulkarni, J. Sex and gender differences in schizophrenic psychoses—a critical review. Arch Womens Ment Health 21, 627–648 (2018).

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  • Schizophrenia
  • Psychosis
  • Sex
  • Gender
  • Symptoms
  • Risk
  • Course
  • Estrogens
  • Prolactin