Abstract
The identification of sex differences in schizophrenia is not new, since even Kraepelin described dementia praecox as a disorder primarily afflicting young men (Kraepelin, 1893). Since then, the literature has shown that schizophrenic men and women differ in terms of age at onset, symptom expression, neurobiological factors, course, treatment response, incidence and familial transmission. More controversial is the literature on sex differences in cognition and structural brain abnormalities in schizophrenia. However, many investigators would now agree that sex modifies the phenotypic expression of schizophrenia. It remains a testable hypothesis whether sex is a risk factor, i.e. has etiological consequences for the illness. This review will summarize the literature on sex differences in the epidemiology, genetics and the brain in schizophrenia. That is, what are the differences in the phenomenology of the disorder? Do they impact the incidence and/or prevalence? How have investigators attempted to explain sex differences in terms of genetic transmission and the neuroanatomy of schizophrenia?
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