Schizophrenia spectrum and other psychotic disorders.

Since its earliest conceptualization, schizophrenia has been considered a disorder of "young men." Contemporary research suggests that there are sex differences in schizophrenia that are both transdiagnostic and representative of general sex/gender differences across the psychopathology spectrum. This chapter selectively summarizes representative sex/gender differences in clinical expression, epidemiology, risk factors, treatment, as well as course and outcome in schizophrenia.

Seasonality of cerebrospinal fluid monoamine metabolite concentrations and their associations with meteorological variables in humans.

Seasonal variations in neurotransmitter parameters have been previously reported in humans. However, these studies have involved small sample sizes and have not examined possible relationships with meteorological variables. We compared cerebrospinal fluid (CSF) concentrations of the major monoamine neurotransmitter metabolites (5-HIAA, HVA, and MHPG) in 188 healthy controls (80 men, 108 women) in relationship to age, sex, BMI, and available meteorological variables.

Sex versus gender differences in schizophrenia: The case for normal personality differences.

Schizophrenia has generally been viewed as having a unique preschizophrenia personality or destructive to the personality post-onset. This view is reflected in the scarcity of studies of personality in schizophrenia with the exception of schizotypal personality considered by many as an endophenotype of schizophrenia. What is missing is the study of personality as independent of schizophrenia and as a potential source of schizophrenia heterogeneity.

Rethinking Thought Disorder.

It has been 30 years since Holzman introduced a special issue of the Schizophrenia Bulletin entitled “Thought Disorder in Schizophrenia.” He pointed out in his Editor’s Introduction that in contrast to the explosion of interest at that time in the biological aspects of schizophrenia, there were important areas of study that represented “..

Is perseveration uniquely characteristic of schizophrenia?

Evidence for the existence of categorically distinct disorders such as schizophrenia, bipolar disorder, and major depression is mixed: neuropsychological impairments may be similar in schizophrenia and bipolar disorder; schizophrenia and major depression show similar neuropsychological and frontal lobe disturbances; and overlap in biochemical anomalies among the disorders has also been reported. Interestingly, there are very few studies that directly compare all diagnoses. The present study compares cognitive perseveration in these three diagnostic groups using the Wisconsin Card Sorting Task (WCST) to examine performance across patients with schizophrenia (n=143), bipolar disorder (n=25) and major depression (n=21).

Intact Wisconsin Card Sorting Test performance: implications for the role of executive function in schizophrenia.

Objectives: The present study sought to examine patients with schizophrenia who are able to perform adequately on the Wisconsin Card Sorting Test (WCST), which is a test that is usually challenging for individuals with schizophrenia due to common problems in executive function.

Method And Design: Patients' WCST performance was classified as either 'intact' (fewer than 15% perseverative errors) or 'impaired' (15% or greater). Individuals with intact performance (N=61; 36.

Sex, gender, and neuropsychological functioning in schizophrenia.

Sex and gender represent substantially different concepts. While there are consistent sex differences reported on selected neuropsychological tasks, there is no systematic literature on comparable gender differences. We examined sex and gender effects on seven domains of neuropsychological functioning among 197 schizophrenia/schizoaffective patients and 94 healthy individuals.

At issue: Sex and gender in schizophrenia.

Using data collected in a study of sex differences in schizophrenia, I undertook this study to show the utility of distinguishing between sex and gender in the study of schizophrenia. Schizophrenia and schizoaffective disorder were combined to yield 213 patients (141 men, 72 women). There were 98 healthy controls (41 men, 57 women).

Socioeconomic status of origin and the clinical expression of Schizophrenia.

The concentrated focus on biology during the "decade of the brain" has resulted in decreased attention to the indisputable influence of psychosocial and sociocultural factors in the expression of schizophrenia. The aim of this study was to evaluate the relationship between the socioeconomic background of the origin and the clinical manifestation of schizophrenia. Parent socioeconomic information and clinical symptom data from 120 (84 men and 36 women) schizophrenia and schizoaffective patients were analyzed.

Age of menarche and schizophrenia onset in women.

Objective: The "estrogen hypothesis" posits that this hormone serves as a protective factor in the development of schizophrenia. If true, then it is expected that the earlier the age of menarche, the later the onset of schizophrenia (as has been reported by some investigators). This study attempts to replicate this relationship in a sample of women with schizophrenia and schizoaffective disorder.

Comparative effect of atypical and conventional antipsychotic drugs on neurocognition in first-episode psychosis: a randomized, double-blind trial of olanzapine versus low doses of haloperidol.

Objective: The effect of antipsychotic medication on neurocognitive function remains controversial, especially since most previous work has compared the effects of novel antipsychotic medications with those of high doses of conventional medications. This study compares the neurocognitive effects of olanzapine and low doses of haloperidol in patients with first-episode psychosis.

Method: Patients with a first episode of schizophrenia, schizoaffective disorder, or schizophreniform disorder (N=167) were randomly assigned to double-blind treatment with olanzapine (mean modal dose= 9.

Cognitive functioning, cortisol release, and symptom severity in patients with schizophrenia.

Background: There is substantial evidence of dysregulation of cortisol secretion, hippocampal abnormalities, and memory deficits in schizophrenia and other psychotic disorders. Research also suggests that cortisol secretion augments dopaminergic activity, which may result in increased symptom expression in this clinical population.

Methods: We examined the relations among cortisol release, cognitive performance, and psychotic symptomatology.

Racial effects on neuropsychological functioning in schizophrenia.

Objective: This study assessed the effects of race on neuropsychological functioning in patients with schizophrenia.

Method: A total of 160 patients with schizophrenia completed an extensive neuropsychological test battery. Scores were standardized to a group of 99 psychiatrically and physically healthy subjects and categorized into seven functional domains: concentration, executive function, language, motor function, spatial memory, verbal memory, and visual processing.

Age at onset and sex differences in corpus callosum area in schizophrenia.

Previous research on neuropsychological function among schizophrenia patients suggests that typical onset males (first psychiatric hospital admission before age 25) and typical onset females (first admission after age 25) may exhibit less lateralization of behavioral function ('hypolateralization') than atypical onset males and atypical onset females. To explore whether these differences were reflected in corpus callosum area, brain morphometric data from a large sample of subjects diagnosed with schizophrenia were analyzed. Typical onset females and typical onset males were compared to atypical onset females and atypical onset males on corpus callosum area.

Race in the "decade of the brain".

Despite NIMH efforts to facilitate the study of women and minorities in federally funded schizophrenia research, there is a significant lack of information about race differences in brain morphology and neuropsychological function in schizophrenia. A review of three major psychiatric journals between 1994 and 1996 revealed that only 14 (2.8%) of 502 schizophrenia articles reported the results of race analyses.

Schizophrenia, substance use, and brain morphology.

The high rate of comorbid substance abuse in schizophrenia and the consistently poor outcome of this comorbidity are well established findings in the research literature. However, the reasons for the high rate of comorbidity are not adequately understood, and the question of why some patients with schizophrenia abuse substances and others do not remains unanswered. There is widespread agreement about the clinical heterogeneity of schizophrenia, and there is some evidence suggesting that the heterogeneous clinical presentation may reflect a parallel underlying heterogeneity of brain morphology.

Brain torque and sex differences in schizophrenia.

The opposing asymmetry of the frontoparietal brain regions has been referred to as 'torque' and may be used as an index of speed of neurodevelopment. It has been recently suggested that torque is minimized in male schizophrenia, reflecting anomalous neurodevelopment. This study examined volumetric and linear torque in a group of 20 schizophrenia patients and 20 healthy individuals; all were right-handed and under the age of 46 years.

Sex differences in verbal IQ-performance IQ discrepancies among patients with schizophrenia and normal volunteers.

Substantial verbal IQ (VIQ)-performance IQ (PIQ) discrepancies may reflect brain dysfunction. The authors examined 159 patients with schizophrenia (115 men and 44 women) or schizoaffective disorder (25 men and 19 women) and 79 normal participants (33 men and 46 women), calculated mean VIQ-PIQ discrepancy scores by sex and diagnosis, and identified persons with large VIQ-PIQ discrepancies (15-point difference in either direction). Schizophrenic/schizoaffective men had a larger mean VIQ-PIQ discrepancy than did other groups.

Sex-onset effects on neuropsychological function in schizophrenia.

Heterogeneity of results continues to hamper schizophrenia research. The examination of sex differences in the effort to reduce this heterogeneity has had mixed results in neuropsychology. We have begun to examine the validity of both sex and onset age to define early-onset male and late-onset female prototypes of the disorder.

Clinical features of schizophrenia in a woman with hyperandrogenism.

Ample evidence supports sex differences in the clinical features of schizophrenia. In this regard, estrogen may contribute to later onset and less severe course of illness in women. Direct investigation of hormonal status in schizophrenia is extremely difficult.

Childhood behavioral characteristics and adult brain morphology in schizophrenia.

It is well established that many schizophrenia patients manifest behavioral dysfunction long before the onset of clinical symptoms of illness. Some show signs of motor and socioemotional deficit as early as infancy. The present study examines the relations among childhood neuromotor, affective and behavior characteristics, and the association of these factors with adult brain morphology (MRI) in schizophrenia patients.

Sex differences in neuropsychological functioning among schizophrenic patients.

Objective: The view of schizophrenic men as having poorer premorbid development, earlier age at onset, and worse outcome than schizophrenic women predicts greater neuropsychological impairment in the former than the latter. The authors examined in detail neuropsychological functioning in a large group of schizophrenic patients and a healthy comparison group.

Method: Neuropsychological functioning in 132 male and 63 female patients with schizophrenia or schizoaffective disorder was extensively studied and compared with that of 99 (40 male, 59 female) healthy individuals.