We studied a population-based sample of 232 firstonset cases of schizophrenia aged 12 to 59 years at first admission retrospectively back to illness onset and prospectively up to 11.2 years later. We compared them wit...We studied a population-based sample of 232 firstonset cases of schizophrenia aged 12 to 59 years at first admission retrospectively back to illness onset and prospectively up to 11.2 years later. We compared them with psychiatrically healthy age- and sexmatched population controls and equally matched firstadmission patients diagnosed with major depression. At schizophrenia onset women are several years older than men. The social factors tested did not explain the finding. Women's higher level of social development at onset is associated with a better medium-term functional and social outcome. Prodromal schizophrenia and depression are equal in length and diagnostically distinguishable only after the onset of positive symptoms. The sex difference in age at onset, invariable across cultures and ethnicities, is explained by a protective effect of oestrogen, which down-regulates D2 receptors. A higher genetic load antagonizes this effect. Long-term symptom-related illness course exhibits a plateau after three years, the positive symptom dimension after two years, the depressive and the negative dimensions do so after three to five years. The most prevalent symptom is depressive mood. Male first episodes are more frequent and more severe in the first half of life, female ones in the second half. Aetiological conclusions will be drawn.展开更多
基金Supported by The German Research Foundation(DFG)as part of the Special Research Branch(Sonderforschungsbereich)258 at the Central Institute of Mental Health from January 1,1987 to December 30,1998 and from January 1,1999 to May 31,2012 as an independent project
文摘We studied a population-based sample of 232 firstonset cases of schizophrenia aged 12 to 59 years at first admission retrospectively back to illness onset and prospectively up to 11.2 years later. We compared them with psychiatrically healthy age- and sexmatched population controls and equally matched firstadmission patients diagnosed with major depression. At schizophrenia onset women are several years older than men. The social factors tested did not explain the finding. Women's higher level of social development at onset is associated with a better medium-term functional and social outcome. Prodromal schizophrenia and depression are equal in length and diagnostically distinguishable only after the onset of positive symptoms. The sex difference in age at onset, invariable across cultures and ethnicities, is explained by a protective effect of oestrogen, which down-regulates D2 receptors. A higher genetic load antagonizes this effect. Long-term symptom-related illness course exhibits a plateau after three years, the positive symptom dimension after two years, the depressive and the negative dimensions do so after three to five years. The most prevalent symptom is depressive mood. Male first episodes are more frequent and more severe in the first half of life, female ones in the second half. Aetiological conclusions will be drawn.
