Comparison of the long-term treatment outcomes of women and men diagnosed with schizophrenia over a period of 20 years. A prospective study

Abstract Numerous studies into the differences in course of schizophrenia between women and men produce contradictory results. Few research teams undertook long-term prospective observations. Objective To assess the long-term clinical and social outcomes of treatment and the subjective quality of life in the group of women and men diagnosed with schizophrenia over a period of 20 years. Group and method A total of 57 people: 34 (60%) women and 23 (40%) men with DSM III diagnosis of schizophrenia and DSM IV T-R re-diagnosis after 12 years, were examined during their index hospitalization and again at 7, 12, and 20 years thereafter. The examination instruments were: the Anamnestic and Catamnestic Questionnaire, the GAF scale, the BPRS-LA, the DSM III Axis V social scale, CFI and the Lehman Quality of Life Interview. Results At the start of the study there were significant inter-gender differences concerning age at onset (p = 0.027), age at first psychiatric hospitalization (p = 0.033), social functioning (p = 0.009), marital status (p = 0.014), social contacts (0.009), schizoid and schizotypal personality disorders (p = 0.006) and symptoms severity (p = 0.045). However, after 7, 12, and 20 years from index hospitalization, no significant differences were found in any of the above mentioned indicators. In terms of subjective QoL assessment at long-term follow-ups, the women had better, but not statistically significant results than the men. Conclusions 1. The initial differences between men and women in terms of symptoms severity in favour of women fade out in 20-year course of illness. 2. Over the years of illness, differences between men and women in terms of social and professional functioning, and subjective quality of life are not statistically significant, but a trend towards more favourable outcome in women is observed. 3. Over the course of the illness, men get married more frequently, which improves their social status.