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Sex differences in prevalence and clinical correlates of insomnia in Chinese patients with chronic schizophrenia

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Abstract

Objective

It is generally recognized that there are sex differences in many aspects of schizophrenia. The main purpose of this study was to investigate the sex differences in the prevalence and clinical correlates of insomnia in patients with chronic schizophrenia.

Methods

A total of 957 patients who met the DSM-IV diagnostic criteria for schizophrenia were recruited in this cross-sectional study (male/female = 630/327). Demographic, clinical, and insomnia data were collected using self-reported questionnaires. Fasting blood samples were collected to evaluate the status of blood lipids. Psychopathological symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS).

Results

The prevalence rate of insomnia in female patients with schizophrenia was significantly higher than that in male patients (17.3% for males and 26.3% for females; χ2 = 10.74, p = 0.001). Regression analysis showed that in male patients, insomnia was independently associated with severe PANSS positive symptoms, severe PANSS depressive factor, and high levels of low-density lipoprotein levels, while in female patients, insomnia was associated with low education level, high PANSS depressive factor, and high levels of apolipoprotein B levels.

Conclusion

This study illustrates that insomnia is more frequent in female than male schizophrenia patients, and that there are differences in the clinical correlates of insomnia by sex, suggesting that sex differences should be considered in prevention and treatment strategies for coexisting insomnia in schizophrenia patients.

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Acknowledgements

We thank all the clinical psychiatrists and nurses in Guangzhou Huiai Hospital and Wuhan Xinzhou Mental Health Center for all of their hard work and significant contributions toward the study.

Funding

Funding for this study was provided by the National Natural Science Foundation of China (31300848), National Key Research and Development Program of China [2017YFC1310405], CAS International Cooperation Research Program (153111KYSB20190004), CAS Pioneer Hundred Talents Program and the CAS Key Lab of Mental Health. The funding sources had no specific involvement in the study.

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Authors and Affiliations

  1. Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Chaoyang District, Beijing, 100101, China

    Rongrong Zhu, Dongmei Wang, Huixia Zhou, Wenjia Wang, Shuochi Wei, Li Wang & Xiang-Yang Zhang

  2. Department of Psychology, University of Chinese Academy of Sciences, Beijing, China

    Rongrong Zhu, Dongmei Wang, Huixia Zhou, Wenjia Wang, Shuochi Wei, Li Wang & Xiang-Yang Zhang

  3. Beijing HuiLongGuan Hospital, Beijing, China

    Dachun Chen & Meihong Xiu

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  1. Rongrong Zhu
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Correspondence to Xiang-Yang Zhang.

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Zhu, R., Wang, D., Zhou, H. et al. Sex differences in prevalence and clinical correlates of insomnia in Chinese patients with chronic schizophrenia. Eur Arch Psychiatry Clin Neurosci 273, 601–611 (2023). https://doi.org/10.1007/s00406-022-01473-x

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