Schizophrenia in women: a review of unique aspects regarding course, management, and challenges across the lifespan.

Abstract

Purpose of review: This review of the latest literature aims to underscore some unique characteristics of schizophrenia in women and to explore the role of hormonal fluctuations and life-stage stressors in its pathogenesis and management. It summarizes the emerging evidence-based recommendations on biological and psychosocial interventions, with the goal to raise awareness of some gender-specific issues and the ultimate intent to optimize outcomes for this patient population.

Recent findings: Schizophrenia affects men and women differently due to gender-specific biological, psychological, social, and cultural factors. Hormonal changes through the woman's reproductive life are associated with differences in disease expression, response to treatment, and treatment adjustments.

Summary: Schizophrenia is a chronic and serious mental illness associated with significant personal and societal burden and with important sexual differences in presentation, course, and management, attributed at least in part to hormonal changes and other factors (e.g. medication compliance, drug interactions, social and cultural characteristics). Periods of high hormonal flux, such as pregnancy, postpartum, and the menopause transition, pose additional challenges concerning psychiatric stability and treatment efficacy and safety. Becoming familiar with important gender-specific characteristics including biological, psychological and sociocultural determinants can lead to adjustments in management and, ultimately, to improved outcomes.