Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-25T08:41:37.146Z Has data issue: false hasContentIssue false
  • English
  • Français

The Epidemiology of Early Schizophrenia

Influence of Age and Gender on Onset and Early Course

Published online by Cambridge University Press:  06 August 2018

H. Häfner ,
K. Maurer ,
W. Löffler ,
B. Fätkenheuer ,
W. An Der Heiden ,
A. Riecher-Rössler ,
S. Behrens  and
W. F. Gattaz
H. Häfner*
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
K. Maurer
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
W. Löffler
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
B. Fätkenheuer
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
W. An Der Heiden
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
A. Riecher-Rössler
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
S. Behrens
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
W. F. Gattaz
Affiliation:
Central Institute of Mental Health, PO Box 12 21 20, D-68072 Mannheim, Germany
*
∗Correspondence.
Get access Rights & Permissions [Opens in a new window]

Abstract

For the investigation of the early course of schizophrenia starting from onset, the standardised Interview for the Retrospective Assessment of the Onset of Schizophrenia was developed and validated. In a representative sample of 267 first-admitted German schizophrenics of a broad diagnosis from a population of 1.5 million, the age at which different diagnostic and onset definitions were satisfied, the symptoms at the time of the interview, and the accumulation of positive and negative symptoms until first admission were assessed. Comparison between the two sexes and three age groups yielded hardly any differences in the accumulation of symptoms and their course until first admission, except for a slightly shorter period of negative symptoms in young males and a slightly longer one in older women – which contradicts prevailing opinion. At the time of the interview, no significant sex differences were found with respect to the core symptoms of schizophrenia (negative and first-rank symptoms), but clear and substantial differences emerged in disease behaviour. The significantly higher age at first onset in women is explained, on the basis of animal experiments and a clinical study, by the neuromodulatory effect of oestrogen on D2 receptors and by a higher vulnerability threshold in women.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 164 , Issue S23: Integrated Approach to Schizophrenia , April 1994 , pp. 29 - 38
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angermeyer, M. C. & Kühn, L. (1988) Gender differences in age at onset of schizophrenia: an overview. European Archives of Psychiatry and Neurological Sciences, 237, 351–364.Google Scholar
Angermeyer, M. C., Goldstein, J. M. & Kühn, L. (1989) Gender differences in schizophrenia: rehospitalization and community survival. Psychological Medicine, 19, 365–382.Google Scholar
Biehl, H., Maurer, K., Jablensky, A., et al (1989) The WHO Psychological Impairments Rating Schedule (WHO/PIRS). I. Introducing a new instrument for rating observed behaviour and the rationale of the psychological impairment concept. British Journal of Psychiatry (suppl. 7), 68–70.Google Scholar
Birnbaum, K. (1923) Der Aufbau der Psychose. Grundzüge der psychiatrischen Strukturanalyse. Berlin: Springer.CrossRefGoogle Scholar
Bleuler, M. (1972) Die schizophrenen Giestesstörungen im Lichte langjähriger Kranken- und Familiengeschichten. Stuttgart: Thieme.Google Scholar
Castle, D. J. & Murray, R. M. (1990) Sex and schizophrenia. Psychological Medicine, 21, 565–575.Google Scholar
Crow, T. (1982) Two syndromes in schizophrenia? Trends in Neuroscience, 48, 351–354.Google Scholar
DiPaolo, T. & Falardeau, P. (1985) Modulation of brain and pituitary dopamine receptors by estrogens and prolactin. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 9, 473–480.Google Scholar
Dohrenwend, B. S. (ed.) (1981) Stressful Life Events and their Contexts. New York: Neale Watson.Google Scholar
Fätkenheuer, B., Riecher-Rössler, A., Löffler, W., et al (1992) Social biography in schizophrenic patients. Abstracts of Committee of AEP Psychiatric Epidemiology and Social Psychiatry Section, p. 71.Google Scholar
Fields, J. Z. & Gordon, J. H. (1982) Estrogen inhibits the dopaminergic supersensitivity induced by neuroleptics. Life Sciences, 30, 229–234.CrossRefGoogle ScholarPubMed
Häfner, H., Riecher, A., Maurer, K., et al (1989) How does gender influence age at first hospitalization for schizophrenia? A transnational case register study. Psychological Medicine, 19, 903–918.CrossRefGoogle ScholarPubMed
Häfner, H., Behrens, S., de Vry, J., et al (1991a) An animal model for the effects of estradiol on dopamine-mediated behavior: implications for sex differences in schizophrenia. Psychiatry Research, 38, 125–234.CrossRefGoogle ScholarPubMed
Häfner, H., Fätkenheuer, B., an der Heiden, W., et al (1991b) Difference selon le sexe dans l'ˇge d'apparition, la symptomatologie et l'évolution de la schizophrenic Santé mentale au Quebec, 14, 77–98.Google Scholar
Häfner, H., Maurer, K., Löffler, W., et al (1991c) Schizophrenic und Lebensalter. Nervenarzt, 62, 536–540.Google Scholar
Häfner, H., Behrens, S., de Vry, J., et al (1991d) Warum erkranken Frauen später an Schizophrenic? Nervenheilkunde, 10, 154–163.Google Scholar
Häfner, H., Riecher, A., Maurer, K., et al (1991e) Geschlechtsunterschiede bei schizophrenen Erkrankungen. Fortschritte der Neurologie und Psychiatrie, 59, 343–360.Google Scholar
Häfner, H., Riecher-Rössler, A., Hambrecht, M., et al (1992) IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophrenia Research, 6, 209–223.Google Scholar
Hambrecht, M., Maurer, K., & Häfner, H. (1992) Gender differences in schizophrenia in three cultures. Social Psychiatry and Psychiatric Epidemiology, 27, 117–121.Google Scholar
Harris, M. J. & Jeste, D. V. (1988) Late-onset schizophrenia: an overview. Schizophrenia Bulletin, 14, 39–55.Google Scholar
Hruska, R. E. (1986) Elevation of striatal dopamine receptors by estrogen: dose and time studies. Journal of Neurochemistry, 47, 1908–1915.Google Scholar
Huber, G., Gross, G. & Schüttler, R. (1979) Schizophrenie: Verlaufs- und sozial-psychiatrische Langzeituntersuchungen an den 1945 bis 1959 in Bonn hospitalisierten schizophrenen Kranken. Monographien aus dem Gesamtgebiet der Psychiatrie. Berlin; Heidelberg; New York: Springer.CrossRefGoogle Scholar
Ideler, K. W. (1847) Der religiose Wahnsim. Schwetschke, Halle.Google Scholar
Jablensky, A., Sartorius, N., Ernberg, G., et al (1992) Schizophrenia: manifestations, incidence, and course in different cultures (a World Health Organization ten-country study). Psychological Medicine (monograph suppl. 20).Google Scholar
Kraepelin, E. (1909–15) Psychiatrie. Vols 1–4. Leipzig: Barth.Google Scholar
Labrie, F., Beaulieu, M., Caron, M., et al (1978) The adenohypophyseal dopamine receptor: specificity and modulation of its activity by estradiol. In Proceedings of International Symposium on Prolactin (eds Robin, C. & Harter, M.), pp. 121–136. Amsterdam: Elsevier/North-Holland Biomedical Press.Google Scholar
Leonhard, K. (1972) Aufteilung der endogenen Psychosen in der Forschungsrichtung von Wernicke und Kleist. In Klinische Psychiatrie 1 (2nd edn) (eds Kisker, K. P., Meyer, J. E., Müller, M., et al), pp. 183–212. Berlin: Springer (Psychiatrie der Gegenwart, Vol. I/1).Google Scholar
Raymond, V., Beaulieu, M., Labrie, F., et al (1978) Potent antidopaminergic activity of estradiol at the pituitary level of prolactin release. Science, 200, 1173–1175.Google Scholar
Riecher-Rössler, A., Häfner, H. Maurer, K., et al (1992) Schizophrenic symptomatology varies with serum estradiol levels during menstrual cycle. Schizophrenia Research, 6 (special issue), 114.CrossRefGoogle Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Description and Classification of Psychiatric Symptoms: an Instruction Manual for the PSE and CATEGO System. London: Cambridge University Press.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.