Studying schizophrenia
Introduction
In the modern world, cases of mental health have increased drastically due to many risk
factors in the environment. One of the most severe mental conditions is called schizophrenia.
From a mental health point of view, schizophrenia refers to an acute and chronic mental health
disorder that impairs how a person behaves, feels, and thinks (Andreasen, 2009). Mainly, people
who have schizophrenia appear as they have lost the sense of touch with reality. Among all the
mental disorders, schizophrenia is not common, but its signs and symptoms are severe and
disabling. Besides, the mental condition is among the most severe mental illnesses where at least
one person in a hundred people is predisposed to develop schizophrenia over a lifetime
(Andreasen, 2009). From a medical perspective, some diseases affect males, while others affect
females. However, most illnesses affect both males and females. In that regard, schizophrenia is
a mental disorder that affects both males and females. However, there may be some disparities in
how the disease affects men and women in terms of age, risk factors, and treatment procedures.
Thus, the primary purpose of this paper is to study schizophrenia in young men and women.
Medical Perception of Schizophrenia in Young Women and Men
Young women and men have different outcomes of schizophrenia in terms of disease
severity, symptoms, age of onset, and the number of treatments. Medical research shows that
young men have a higher propensity to negative symptoms of the mental disorder, and they also
show an earlier age at onset. Moreover, men co-morbid abuses of substances than that in females
and also have lower social functioning (Andreasen, 2009). Conversely, young women show late
age onset of the disorder with more severe and effective symptoms than young men. Men
develop schizophrenia between 16 and 25 years old. In other words, men are predisposed to
SCHIZOPHRENIA 3
schizophrenia at a slightly earlier age than women. In women, the disorder is likely to occur
several years after men have developed symptoms. Thus, in young women, the illness may
develop after women attain 30 years of age. The central concept to consider in the study are sex
differences in age-onset on men and women, the sex difference in symptoms, sex dependence
factors in schizophrenia, and sex difference response to treatment.
Sex Difference in Age-Onset on Schizophrenia
According to the National Institute of Mental Health, young men and women prone to
getting schizophrenia. Both women and men are likely to suffer from mental disorders, but men
are likely to develop symptoms of schizophrenia at a slightly earlier age than women (Howard &
Jeste, 2011). Most men develop symptoms of the disorder in their teenage. On average, men are
diagnosed with schizophrenia in their late teens up to 25 years old. On the other hand, women
are diagnosed in their early 30s. On average, women develop the disorder in their late 20s. In
other words, both men and women have the same prevalence of the mental disease, and the
difference that women onset is three to five years later than men. Young men have a single peak
age for onset of the disorder, which has been set at age 21 and 25 (Howard & Jeste, 2011). On
the contrary, women have two peak ages of onset. For young women, the onset is between 25
and 30 years old, but for other women, the onset after 45 years old. Moreover, young women
with this illness have more admission seasonality than men due to the two peaks of onset ages in
females.
Sex Difference in Symptoms of Schizophrenia
Before considering the difference in symptoms of schizophrenia in young men and
women, there are common symptoms in both. On average, symptoms of this illness begin
between ages 16 and 30 (Kirkbride et al., 2012). Both young men and women display three
SCHIZOPHRENIA 4
categories of symptoms, namely cognitive, negative, and positive. First, positive symptoms are
recognized when a patient of schizophrenia develops psychotic behaviors that are not identifiable
in healthy people. Most of the patients with positive symptoms tend to lose connection with
reality. Some of the positive symptoms include agitated body movement, dysfunctional thinking,
delusions, and hallucination. The second category of symptoms of schizophrenia is negative
symptoms (Erritty & Wydell, 2013). These symptoms are associated with disruptions to normal
behavior and emotions. Thus, young men and women reduce their communication, difficulty in
sustaining activities, reduced feelings of pleasure, and reduced expression of emotions. The last
common category of symptoms in young men and women is cognitive. Cognitive symptoms are
subtle to some patients, while for others, they are severe. These symptoms include difficulty in
paying attention, poor executive functioning, and poor working memory.
Even with typical symptoms of schizophrenia in young men and women, there exist sex
differences in the symptoms of schizophrenia. First, male patients of schizophrenia appear to
display more severe clinical features and negative symptoms that female patients of
schizophrenia. Therefore, young men with the disorder will have more social withdrawal, abuse
of substances, and other incongruent impacts than women suffering from the illness (Kirkbride et
al., 2012). On the contrary, young women with this disorder tend to display more depressive and
mood disturbances symptoms than males. Surprisingly, sex-specific symptoms in men with
schizophrenia predispose men to a higher risk of this disease than women. The age onset also
determines the category of symptoms to men and women with schizophrenia present. Young
women with late-onset of the disease present less severe negative symptoms and also display
more positive symptoms such as persecutory delusion and hallucination.
SCHIZOPHRENIA 5
Moreover, both young men and women with schizophrenia have cognitive impairment
characterized by delay memory, language, and immediate memory loss. However, men with
schizophrenia present more serious cognitive symptoms in terms of direct and delayed memory
than women with late communication, attention, and visuospatial indices (Erritty & Wydell,
2013). Different hormones also cause symptoms of schizophrenia in women and men. For
example, lack of adequate and surplus dopamine hormone explain the negative and positive
symptoms of schizophrenia in young men and women. However, some difference in genes in
men and women explains some differences in symptoms. One genetic component that explains
the difference in symptoms of schizophrenia in young men and women is the GABAergic
regulation of the anterior cingulate cortex function (Bristow et al., 2015). Men with lower levels
of GABAergic genes tend to be at a higher risk of presenting more severe symptoms of
schizophrenia than women
Risk Factors of Schizophrenia in Young Men and Women
Several factors predispose men and women to the risk of developing a mental disorder.
The first risk factor is genes and the environment. Psychiatric research has shown that
schizophrenia is genetically connected and can run in families. Medical researchers believe that
different types of genes can cause schizophrenia, but there is no single gene can solely cause the
disorder (Kirkbride et al., 2012). Besides, the scientist believes that environmental risk factors
such as psychosocial factors, birth problems, malnutrition before birth, and exposure to viruses
can cause schizophrenia.
The second risk factor of the disease in men and women is the brain structure and
chemistry. Mainly, any complex brain imbalance and chemical reactions can affect
neurotransmitters, glutamate, and dopamine. The impact of brain impairment can trigger
SCHIZOPHRENIA 6
schizophrenia. Some scientists also associate schizophrenia with problems of the brain during
development before birth. In young men and women, the brain undergoes a major
transformation, especially during puberty. Therefore, changes in the brain can trigger psychotic
symptoms to individuals who are predisposed to the brain, and genetic risk factors of
schizophrenia (Kirkbride et al., 2012). Overall, the childhood history of a person is essential in
determining the risk factors of schizophrenia. For example, young women who have been
subjected to physical abuse in their childhood are at higher risk of suffering depressive and
psychotic symptoms of schizophrenia than young men.
Sex Differences in Response to Schizophrenia Treatment
Young men and women with schizophrenia can be subjected to several therapies and
treatments. Causes of Schizophrenia are not known, and doctors depend on risk factors and
symptoms when treating the disorder. In other words, the treatments aim at eliminating
symptoms of the disease. Some medicines are used to treat both men and women. Some of the
primary procedures and therapies include antipsychotics, psychosocial treatment, and
coordinated specialty care (Juan et al., 2011). First, antipsychotic medicines are administered
daily in liquid or pill form. However, some of these medications are administered monthly
through injections. Antipsychotics are reliable in managing symptoms of schizophrenia, but
patients are subjected to side effects that go away afterward. When using this medication, doctors
and patients are advised to work together to determine the best dosage and medication
combination.
The second treatment is psychosocial medication. The medication is essential and helpful
after the doctor and patients determine the best medication combination that works. Thus, young
men and women with this illness are advised to learn and use coping skills that eliminate
SCHIZOPHRENIA 7
symptoms of schizophrenia. The majority of patients are encouraged to participate in
psychosocial medication because it reduces the chances of hospitalization as a result of relapse
(Juan et al., 2011). The last treatment is coordinated specialty care. The therapy is used by
integrating medicine, case management, employment services, supported education, and
psychosocial therapies. Coordinated specialty care is used to reduce the severity of symptoms by
improving the quality of life for patients.
Despite the above treatments and therapies, young men and women respond differently to
the medication. Therefore, it is essential to consider gender-specific treatment strategies when
treating schizophrenia in young men and women. By considering gender, healthcare providers
can determine the best dosage, compliance, and side effects (Juan et al., 2011). Mainly, women
with schizophrenia respond better to medication than men. Young men with schizophrenia
require a higher dosage of antipsychotic drugs than women due to more significant liver
enzymatic clearance in men. Young women need a lesser dosage of antipsychotics because they
still have higher levels of estrogen. Therefore, estrogen therapy is applied to treat schizophrenia
in young women, while adjunctive treatment is used to manage the illness in young men.
Moreover, the majority of antipsychotics are associated with side effects. However,
young women present more side effects than young. Some of the common side effects are the
enhancement of autoimmune proclivity, weight loss, hypertension, and hyperprolactinaemia. On
average, young women have better treatment compliance and present better results after
treatment than young men (Juan et al., 2011). The primary hypothesis that explains why young
women respond better to treatment is their ability to develop social skills. Therefore, treatment
involves reducing the abuse of substances, reducing negative externalization behaviors, and
SCHIZOPHRENIA 8
creating socio-occupational skills. On the other hand, treatments in young women focus on
reducing anxiety, improving co-morbid depression, and affective symptoms.
Sex-Dependent Factors in Schizophrenia in Young Men and Women
Several sex-related factors can be used in the clinical trajectory to treat patients of
schizophrenia. The two main factors are hormone hypotheses and sex chromosome hypotheses.
First, hormone hypotheses are used to demonstrate the compliance of men and women on
treatments and therapies of schizophrenia. In young women, health care providers determine the
levels of female gonadal hormones when treating schizophrenia. Mainly, young women have a
higher level of estrogen hormone that older women who are in post-menopause. Therefore, in
young women, estrogen therapy is used to treat this disorder because young women are in the
first late-onset age of schizophrenia (Kulkarni et al., 2011). In young men, the gonadal hormone
called testosterone plays a significant role in the treatment of schizophrenia.
Men will lower the level of testosterone experience severe symptoms of schizophrenia
(Erritty & Wydell, 2013). Mainly, male patients of schizophrenia with low levels of testosterone
present negative symptoms because the serum testosterone levels increase the severity of
negative symptoms (Kulkarni et al., 2011). Another hormone considered to play a significant
role in the treatment of this disorder in young men and women is oxytocin. Mental research
shows that patients with higher levels of plasma oxytocin exhibit less severe psychotic
symptoms. They have also displayed improvement in their cognitive response because oxytocin
regulates the amount of dopamine in the body.
The sex chromosome hypothesis is used to determine how sex hormones regulate mental
functions in young men and women. Mainly, XX and XY chromosomes have neurodevelopment
role which contributes to cognitive functions. For example, a woman with an abnormal number
SCHIZOPHRENIA 9
of X chromosomes has a higher risk of developing schizophrenia due to motor impairment.
Similarly, a man with an unusual amount of X or Y chromosomes has a higher risk of developing
schizophrenia due to motor impairment (Kulkarni et al., 2011). In that regard, mental health care
providers should consider different formations of sex hormones when determining the best
medication for schizophrenia. In young women, gene mutation of the X chromosome can impair
mental function leading to schizophrenia. In young men, gene mutation of the Y chromosome
can similarly impair mental function leading to schizophrenia.
Conclusion
Schizophrenia is a severe mental disorder that should be handled with ultimate care. In
this paper, exploring gender differences in schizophrenia in young men and women allow people
to understand how to manage patients. Besides, consideration of this disorder offers a significant
insight that helps people to recognize symptoms, disease onset, treatments, and care provision of
patients of schizophrenia based on gender. The information about schizophrenia in young men
and women is relevant in the provision of quality mental health, and healthcare providers should
take the opportunity to generate better treatment and intervention measures to prevent
schizophrenia. Overall, caring for young men and women with schizophrenia is the most crucial
role the healthy people can play to help these patients. Thus, people should not condemn these
patients because schizophrenia is a biological, mental disorder.
SCHIZOPHRENIA 10
References
Andreasen, N. C. (2009). Understanding the causes of schizophrenia. The New England Journal
of Medicine, 340(8):645-647.
Bristow, G.C., Bostrom, J.A., & Haroutunian, V, et al. (2015). Sex differences in GABAergic
gene expression occur in the anterior cingulate cortex in schizophrenia. Schizophr Res,
167(1–3):57–63.
Erritty. P., Wydell, T.N. (2013). Are Lay People Good at Recognising the Symptoms of
Schizophrenia? PLoS ONE 8(1): e52913. https://doi.org/10.1371/journal.pone.0052913 .
Howard, R., Jeste, D. (2011). Late onset schizophrenia. In: Weinberger DR, Harrison PJ,
editors. Schizophrenia. Chichester, West Sussex; Wiley Blackwell.
Juan, R. B ., John, L., William, P. H ., & Samuel. J. K . (2011). Psychological treatment of
schizophrenia: An update. The American Journal of Psychiatry, 158(2), 163-175.
https://doi.org/10.1176/appi.ajp.158.2.163
Kirkbride, J.B., Errazuriz. A., & Croudace, T.J, et al. (2012). Incidence of schizophrenia and
other psychoses in England, 1950 – 2009: a systematic review and meta-analyses. PLoS
ONE, 7(3):e31660.
Kulkarni, J. A., Headey, B, et al. (2011). Estrogens and men with schizophrenia: is there a case
for adjunctive therapy? Schizophr Res, 125(2–3):278–283.
