Just as there are differences in the characteristics of heart disease in men and women, there are significant differences in how schizophrenia strikes the two sexes. Perhaps these sex differences might be traced to different effects of male and female hormones during brain development and/or to their effects on the disease process around the time of puberty. At this time, no one knows exactly why they exist.
Differences in Age of Onset
Schizophrenia usually appears early in the lives of both sexes, but some studies indicate that it may appear slightly earlier in males than in females. The median age is in the early twenties for males. This means half of men showing symptoms for the first time are less than twenty-three years of age.
For women, the median age of onset is in the late twenties. Thus, while many males show obvious signs of the disease in their early twenties, many women tend to develop obvious symptoms in their late twenties to early thirties. Women also seem to experience a faster onset of the disease than men do. Most adults over the age of forty who develop late onset schizophrenia are female.
Differences in Disease Severity
Schizophrenia seems to develop more rapidly in women than in men. When the disease is at its worst, females tend to suffer from its positive symptoms such as hallucinations, delusions, and disorganized or bizarre behavior. But these symptoms are more likely to come and go rather than persist in females. During the remissions, women are more likely to do better than men. They can often function quite well without much impairment. As a group, females also have fewer cognitive problems. Not surprisingly, these features of schizophrenia in women contribute to their generally better chances for recovery.
Is schizophrenia “nicer” to women than to men?
No. It is a serious disease for both sexes. Women are more likely than men to have had a higher level of functioning in their social, school, and work life before becoming ill. Schizophrenia may also take less of a toll on women. Observations like these are based on a very large sample of patients and vary depending on the individual.
A gender difference has also been reported in the incidence of schizoaffective disorder. More women than men are diagnosed with this disorder, particularly its depressive variety.