Abstract
BackgroundChildhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia. A recent large population-based case–control study found that abuse may be a risk factor for schizophrenia in women, but not men. Given the sex differences in onset and clinical course of schizophrenia, we hypothesized that childhood abuse may cause phenotypic differences in the disorder between men and women.MethodsWe examined the prevalence of childhood physical abuse in a cohort of men and women with schizophrenia and schizoaffective disorder. Specifically, we examined differences in positive, negative, cognitive and depressive symptoms in men and women who reported a history of childhood physical abuse. We recruited 100 subjects for a single visit and assessed a history of childhood physical abuse using the childhood trauma questionnaire (CTQ) and clinical symptoms and cognition using the brief psychiatric rating scale (BPRS), the calgary depression scale (CDS) and the repeatable battery of the assessment of neuropsychological status (RBANS) for cognition.ResultsNinety-two subjects completed the full CTQ with abuse classified as definitely present, definitely absent or borderline. Twelve subjects who reported borderline abuse scores were excluded. Of the 80 subjects whose data was analyzed, 10 of 24 (41.6 %) women and 11 of 56 (19.6 %) men reported a history of childhood physical abuse (χ2 = 4.21, df = 1, p = 0.04). Women who reported such trauma had significantly more psychotic (sex by abuse interaction; F = 4.03, df = 1.76, p = 0.048) and depressive (F = 4.23, df = 1.76, p = 0.04) symptoms compared to women who did not have a trauma history and men, regardless of trauma history. There were no differences in negative or cognitive symptoms.ConclusionsWomen with schizophrenia and schizoaffective disorder may represent a distinct phenotype or subgroup with distinct etiologies and may require different, individually tailored treatments.
Highlights
Childhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia
Results were assessed by sex and abuse history, leading to four separate categories: women who had been physically abused, women who had not been physically abused, men who had been physically abused, and men who had not been physically abused
Psychiatric symptoms Women with a history of physical abuse had comparable total brief psychiatric rating scale (BPRS) scores and negative symptoms compared to women without a history of physical abuse and men, regardless of physical abuse history
Summary
Childhood abuse has been implicated as an environmental factor that increases the risk for developing schizophrenia. A recent large population-based case–control study found that abuse may be a risk factor for schizophrenia in women, but not men. Given the sex differences in onset and clinical course of schizophrenia, we hypothesized that childhood abuse may cause phenotypic differences in the disorder between men and women. Women and men with schizophrenia differ with respect to age at onset, disease course, clinical symptoms, cognitive and social performance, and neurobiological factors. Men diagnosed with schizophrenia typically present with an earlier age on onset, have poorer premorbid function, more negative symptoms, and lower social functioning [1, 2]. Et al Child Adolesc Psychiatry Ment Health (2016) 10:5 of illness in men in women, suggesting that schizophrenia is a heterogeneous disorder [6]. Sex differences have important consequences for understanding the etiology and course of schizophrenia, since the incidence rate of early onset schizophrenia in women has been rising linearly since the 1970s, a phenomenon not seen in males [4]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
