Sex Differences in Schizophrenia Across the Reproductive Lifespan

A number of sex differences have been reported in people with schizophrenia in terms of epidemiological data and clinical and social needs. This review examines recent evidence on sex differences in clinical outcomes, medical comorbidities and social risk factors in schizophrenia. Sex-specific personality traits and the effects of childhood maltreatment are relevant in schizophrenia. Insomnia is more common in women and is associated with depressive symptoms and cognitive impairment. Differences in antipsychotic dose requirements, risk of hospitalization and adverse events between men and women with schizophrenia have been reported and vary with age. The association between negative symptoms and 10-year cardiovascular risk are more common in men. Hyperglycaemia and dyslipidaemia are potential targets for sex stratification in the treatment of schizophrenia. Living without a spouse is associated with an increased risk of schizophrenia, which is higher in men than in women. Loneliness and social isolation are positively associated with clinical symptoms in men. The mental, physical and social needs of men and women with schizophrenia differ. This should be recognised when planning sex-specific programmes for psychosis.