[1][2][3] Men and women exhibit different rates of incidence and prevalence, age at onset, symptom expression, course of illness, and response to treatment.
[2][3][4] Reviews of the literature suggest that understanding the implications of sex differences on schizophrenia may help inform individualized treatment and positively affect outcomes.
[7] 2005 and 2008 studies of prevalence rates of schizophrenia estimate that the lifetime likelihood of developing the disorder is 0.3–0.7%, and did not find evidence of sex differences.
[18] Longitudinal studies have found evidence of sex differences in presence of psychosis, global outcome, and recovery across periods of 15–20 years.
[19][20][21] Several studies have demonstrated that women with schizophrenia are more likely to exhibit significantly greater reduction in psychotic symptoms, as well as better cognitive and global functioning relative to men.
[19] Further, there is consistent evidence of higher mortality rates, suicide attempts and completions, homelessness, poorer family and social support in men compared to women.
[19] Clinical trials examining sex differences in the efficacy of atypical antipsychotic medications found greater rates of symptom reduction in women compared to men.
[22] However, women are at a greater risk for experiencing weight gain and developing metabolic syndrome as a result of antipsychotic medication use.
[13][19] Additionally, these factors are also associated with reduced social network size and lower marriage rates in men with schizophrenia compared to women.
In early adolescence, sex-related differences in cannabis use have been observed, with males using more heavily than females in the general population and in those at risk for developing schizophrenia.
[31] There is evidence that these differences could in part be attributed to the predictive relationship between levels of testosterone in early adolescence and later cannabis use and dependence.
[33] There is some evidence that heavy, early cannabis use may be associated with impeded cortical maturation in males at a high risk for developing schizophrenia, potentially accelerating the course of illness in these individuals.