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Gender differences in clinical presentation and therapeutic response in schizophrenia

Published online by Cambridge University Press:  26 August 2025

S. Ben Aissa*
Affiliation:
Psychiatry, Razi hospital, Manouba, Tunisia
K. Razki
Affiliation:
Psychiatry, Razi hospital, Manouba, Tunisia
C. Najar
Affiliation:
Psychiatry, Razi hospital, Manouba, Tunisia
A. Larnaout
Affiliation:
Psychiatry, Razi hospital, Manouba, Tunisia
W. Melki
Affiliation:
Psychiatry, Razi hospital, Manouba, Tunisia
*
*Corresponding author.

Abstract

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Introduction

Schizophrenia is a multifaceted psychiatric disorder characterized by disturbances in thinking, emotions, and behavior. It exhibits a diverse spectrum of clinical presentations influenced by various factors, among which gender plays a significant role.

Objectives

To determine the differences in clinical profile and therapeutic response among schizophrenia patients according to gender.

Methods

We conducted a descriptive, cross-sectional, comparative study over a three-month period from January to March 2024, among patients in the post-care service of Psychiatry Department D at Razi Hospital diagnosed with schizophrenia based on DSM-5 criteria. Sociodemographic and clinical data were initially collected from patients’ medical records and then verified and supplemented during direct interviews using a pre-established information sheet. The Positive and Negative Syndrome Scale (PANSS) was used to assess symptom severity in participants.

Results

We enrolled 80 participants, of whom 50 were male (62.5%) and 30 were female (37.5%). The mean age of participants was 42.5 years. Men had higher mean scores on the positive symptoms subscale (75.6±12.05) and negative symptoms subscale (64.8±8.69), while women had higher mean scores on the general symptoms subscale (69.3±15.86). Male patients exhibited a higher prevalence of auditory hallucinations (80%) compared to women (55%), with a statistically significant difference (χ² = 4.32, p < 10-3). Similarly, a higher prevalence of delusional ideas (72%) was observed in men compared to women (45%), also statistically significant (χ² = 5.87, p = 0.02). Regarding therapeutic response, men showed a statistically more significant improvement in positive symptoms like hallucinations and delusional ideas, with an average reduction of 15 points on the PANSS scale compared to 10 points in women (p = 0.02). Conversely, women demonstrated a more favorable response to negative symptoms such as social withdrawal and apathy, with an average reduction of 12 points on the PANSS negative symptoms subscale compared to 8 points in men (p = 0.04).

Conclusions

The observed differences in clinical profiles and therapeutic responses between male and female patients underscore the necessity for tailored treatment approaches aimed at optimizing outcomes and enhancing patient care.

Disclosure of Interest

None Declared

Information

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Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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