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Schizophrenia is a heterogeneous disease, due to the fact that the reasons for its onset are varied, as are the reactions of patients who suffer from it. Some experts relieve that gender is an important factor in this heterogeneity. Ms Ana Cataln has presented her PhD thesis at the University of the Basque Country (UPV/EHU) on this topic, entitled Differences in the prognostic and clinical presentation as a function of gender amongst patients with a primary psychotic episode. She concluded that there are differences between men and women in this matter and that should be taken into account, but there is no evidence to suggest that sex totally conditions this illness.
In order to carry out her thesis, Ms Cataln designed an observational study and limited it to the primary psychotic episode. She analysed 231 patients, selected after establishing the criteria required thereof. For two years she studied the progress of these patients with a primary psychotic episode, evaluating gender solely as a biological feature, i.e. leaving aside its social and cultural connotations.
Later in women
Based on the observation of these patients, according to Ms Cataln, women with a primary psychotic episode in general show symptoms of the illness later and have a greater probability of being married and/or living with their partner and/or children. Moreover, in the case of women it is more common to suffer an acute form of psychosocial stress in the year prior to the onset of the illness. Also, on applying the Cannon-Spoor subscale, which measures the promorbid or prior to the illness adjustment, women obtain better results in late adolescence, adult age and in general. That is, during the lifetime previous to the onset of the first symptoms, appropriately complying with expectations in accord with each age range.
The author of the thesis also used the scale known as PANSS in order to analyse the clinical progress of the patients over the two years the research lasted; this scale is used to measure the gravity of the symptoms of patients with schizophrenia. As the scale shows, differences between the two sexes are, with an occasional exception, scant in the progress at the basal phase of the illness.
Thus, concluded Ms Cataln, the sex does not turn out to be a decisive prognostic factor in the progress of primary psychotic episodes. However, there are differences produced between men and women as regards the characteristics of the psychotic crisis episodes (clinical phenotype) and the author of the thesis underlines that these should be taken into consideration by the doctor.
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