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Gender difference in age at onset of schizophrenia: a meta-analysis

Published online by Cambridge University Press:  08 May 2012

S. V. Eranti ,
J. H. MacCabe ,
H. Bundy  and
R. M. Murray
S. V. Eranti*
Affiliation:
Newham Early Intervention Service, East London Foundation Trust, Stratford Office Village, London, UK
J. H. MacCabe
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London, UK
H. Bundy
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, de Crespigny Park, London, UK
R. M. Murray
Affiliation:
Institute of Psychiatry, King's College London, de Crespigny Park, London, UK
*
*Address for correspondence: S. V. Eranti, Newham Early Intervention Service, East London Foundation Trust, Unit 9, Stratford Office Village, 4 Romford Road, London E15 4EA, UK. (Email: [email protected])
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Abstract

Background

Most studies reporting the gender difference in age at onset of schizophrenia show an earlier onset in males, but vary considerably in their estimates of the difference. This may be due to variations in study design, setting and diagnostic criteria. In particular, several studies conducted in developing countries have found no difference or a reversed effect whereby females have an earlier onset. The aim of the study was to investigate gender differences in age of onset, and the impact of study design and setting on estimates thereof.

Method

Study methods were a systematic literature search, meta-analysis and meta-regression.

Results

A total of 46 studies with 29218 males and 19402 females fulfilled the inclusion criteria and were entered into a meta-analysis. A random-effects model gave a pooled estimate of the gender difference of 1.07 years (95% confidence interval 0.21–1.93) for age at first admission of schizophrenia, with males having earlier onset. The gender difference in age at onset was not significantly different between developed and developing countries. Studies using Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria showed a significantly greater gender difference in age at onset than studies using International Classification of Diseases (ICD) criteria, the latter showing no difference.

Conclusions

The gender difference in age of onset in schizophrenia is smaller than previously thought, and appears absent in studies using ICD. There is no evidence that the gender difference differs between developed and developing countries.

Keywords

Age at onsetgender differenceschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 1 , January 2013 , pp. 155 - 167
Copyright
Copyright © Cambridge University Press 2012

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