Schizophrenia in women is not the same as schizophrenia in men. While the diagnostic criteria for the condition are consistent for individuals of all genders, virtually every other aspect of a person’s experience with schizophrenia can be influenced to some degree by gender.
The Role of Gender With Schizophrenia
A person’s gender can play a role in the types of symptoms they develop, when these symptoms typically become apparent, and how they respond to various forms of treatment.
Gender’s impact on schizophrenia isn’t limited to the disorder itself, as men and women with this also deal with different types of stigma, childcare responsibilities, behavioral expectations, economic pressures, and access to treatment.
What Causes Schizophrenia?
Researchers have not been able to identify a definitive solitary cause of schizophrenia. But they have noted several internal and external factors that can increase a woman’s risk of developing this disorder.
Potential risk factors for schizophrenia in women include:
- Genetic variations
- Exposure to excessive stress or danger
- Being abused during childhood
- Growing up in an impoverished environment
- Being born in late winter or early spring
- Certain complications during pregnancy and birth
- Low birth weight
- Childhood malnutrition
- Abusing psychoactive drugs during adolescents
Symptoms of Schizophrenia in Women
As established in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), schizophrenia can include five types of symptoms:
- Hallucinations: This symptom type involved perceiving things that don’t exist, such as hearing voices or other sounds that have no origin, or seeing light patterns or objects that aren’t really there.
- Delusions: These are rigidly held beliefs that can be easily disproved or that have no basis in reality, such as someone claiming they have special talents or magical powers, or believing that someone else is attempting to control their thoughts.
- Disorganized speech: Someone with this type of symptom will have difficulty communicating in a logical or understandable manner. They may rapidly jump from one topic to the next, respond to questions with unrelated answers, or use words due to sound or rhyme rather than meaning.
- Grossly disorganized or catatonic behavior: Examples of this symptom type include acting with childlike silliness, dressing in a bizarre manner, becoming suddenly and unpredictably agitated, or holding their body in what appears to be a “frozen” posture
- Negative symptoms: This category of symptoms is characterized by diminished expressiveness and motivation, such as speaking with a flat tone, using few gestures, and showing little interest in associating with others.
To be diagnosed with schizophrenia women must exhibit at least two of these symptoms, one of which must be delusions, hallucinations, or disorganized speech.
Though the diagnostic criteria for schizophrenia are the same for all genders, the disorder often affects women differently than it does men.
Mary V. Seeman, MD, a Canadian psychiatrist who specialized in schizophrenia among women, noted that these differences can include:
- Women with schizophrenia are less likely than men to have difficulty with cognitive functions such as memory, concentration, and problem-solving.
- Women with schizophrenia are usually more skilled at reading social cues and masking their symptoms in social situations.
- Women are less likely than men to have negative symptoms.
- Among adults with schizophrenia, women are more likely than men to also experience symptoms of depression.
- For women, schizophrenia symptoms may fluctuate more due to varying estrogen levels throughout the menstrual cycle.
Seeman also reported that about 50% of women with schizophrenia have children, while fewer than 33% of men who have the disorder are parents.
When Is the Typical Onset of Schizophrenia in Women?
Women with schizophrenia will typically begin to exhibit symptoms during their later 20s or early 30s. After this period, the likelihood of female schizophrenia symptoms appearing for the first time steadily declines with age, with one exception.
Researchers with the Beijing Key Laboratory of Mental Disorders identified a slight increase in the onset of schizophrenia symptoms in women ages 40-50.
The Beijing research team also reported that women may account for up to 87% of all people who are diagnosed with schizophrenia after age 40.
Treatment for Women With Schizophrenia
Treatment for people who have schizophrenia typically involves medication and therapy. These general parameters apply to both male and female patients, but that doesn’t mean treatment should be identical for members of all genders.
For example, since women often begin to experience schizophrenia symptoms at an older age than men, female schizophrenia patients may be dealing with a different set of age-related concerns than men are.
Mary V. Seeman, MD, who we mentioned earlier in this post, also identified some key treatment differences between men and women:
- The social and economic challenges of having a serious mental illness mean that many women with schizophrenia live in poverty and don’t have access to adequate childcare, which can undermine their ability to fully engage in treatment.
- Parenting-related stressors are one reason why there may be a greater necessity for family therapy among female schizophrenia patients.
- Fear that they may lose their children has caused some women to stop taking their medication in a misguided attempt to prove that they no longer have schizophrenia.
- If women are given antipsychotic medications at the same dosage level that men receive, they have a greater risk of developing serious side effects.
The impact of gender on treatment for schizophrenia isn’t solely negative, though. Positive gender-related influences include:
- Women are more likely than men to form productive therapeutic alliances with their treatment providers and thus may respond better to various forms of psychotherapy.
- The rate of treatment compliance, or following clinical guidance, is higher among female schizophrenia patients than it is among male patients.
- Gender-based hormonal and metabolic differences mean that when women and men receive equal doses of an antipsychotic medication, more of the drug will reach the women’s brains.
Schizophrenia is a complex mental illness that can be quite challenging to treat. For women, effective personalized treatment must account for the types of gender-based differences that we have discussed in today’s post.
Contact Us About Our Women’s Treatment Center at Montare Behavioral Health
If you are seeking mental health treatment from a provider that understands the unique needs of female patients, Montare Behavioral Health may be the ideal place for you.
Our network of treatment centers in California and Arizona offers focused, gender-appropriate care in safe and highly supportive environments. One of our locations, Montare at the Canyon in Malibu, CA, features an entire facility that is designed solely to serve women. For additional details about our programs and services, or to schedule a free assessment, please visit our Contact page or call us today.
Published 12/10/2024
