Women with schizophrenia spectrum disorder have poorer subjective outcomes than men

Among patients with schizophrenia spectrum disorders, women had poorer subjective recovery-related outcomes and more unmet needs compared with men, according to study results published in Journal of Clinical Psychiatry.

“Later age at onset, higher premorbid functioning, better treatment adherence, better responses to pharmacologic and psychosocial treatments, and more favorable longitudinal clinical and functional outcomes are characteristics often associated with the female sex in schizophrenia spectrum disorders,” Marine Dubreucq, MSc, of the Referral Center for Psychosocial Rehabilitation and Cognitive Remediation at the Alpes-Isère Hospital Center in France, and colleagues wrote. “Sex-related (ie, genetic, biological or developmental) as well as gender-related factors (ie, sociocultural gender norms, pressures and expectations) might explain some of these differences.”

According to the researchers, although research interest in this area is growing, the link between sex/gender and recovery in schizophrenia spectrum disorders remains unclear. Further, specific psychiatric rehabilitation needs among women remain largely unknown. Dubreucq and colleagues aimed to evaluate sex differences in object and subjective recovery factors and psychiatric rehabilitation needs among 1,055 outpatients with schizophrenia spectrum disorder according to DSM-5 diagnosis who were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort between January 2016 and November 2019. They included standardized scales for quality of life, satisfaction with life and well-being, as well as a broad cognitive battery, in the assessment and recorded socially valued roles at enrollment. They also measured functional recovery via the Global Assessment of Functioning scale and personal recovery via the Stages of Recovery Instrument.

Results showed female sex best predicted having more than two socially valued roles in the multivariate analysis (OR = 5.42; 95% CI, 2.34-13.06). Dubreucq and colleagues observed no sex differences for functional recovery or personal recovery. They reported a positive association between female gender and self-stigma (P = .036) and suicidal history (P < .001), as well as a negative association between female gender and quality of life (P = .004) and satisfaction with interpersonal relationships (P = .029), with the latter an area in which women reported more unmet needs (P = .004).

“The inclusion of gender role–specific content in existing programs targeting dysfunctional attitudes (eg, gender-related cognitive biases), self-stigma (eg, self-stigma on parenting role or abilities) or social skills (eg, dating/intimate relationships or parenting abilities) and the development of gender-sensitive recovery-oriented interventions could address the unmet needs of women with [schizophrenia spectrum disorder],” the researchers wrote.