Gender matters in schizophrenia-spectrum disorders: Results from a healthcare users epidemiological study in Malaga, Spain.

PURPOSE: Women suffering from schizophrenia-spectrum disorders may differ from men in clinical course and outcome. Still, those differences can only be portrayed accurately by means of studies that derive information from multiple sources. One such study was performed in a well-defined area supported by a Mental Health Clinical Management Unit in Malaga, Spain. METHODS: Data from 1640 patients (1048 men and 592 women) that were in contact with services during 2008 were examined for the purpose of the present analysis. Gender differences in sociodemographic and clinical characteristics and the role of gender for explaining clinical characteristics (diagnosis, disease severity and service use) beyond potential sociodemographic confounders were explored. RESULTS: The chi-squared analysis results revealed that in comparison to men, women were older, married or widowed/divorced and living as housewives with their families in cities. Genders also differed across diagnoses, with men being at higher risk for suffering from paranoid schizophrenia, while women being at higher risk for persistent delusional, acute/transitory and schizoaffective disorders. Furthermore, men had greater disease severity and higher chances to visit the mental health rehabilitation unit (MHRU). Further regression analyses revealed that after controlling for confounders, gender differences remained significant across diagnoses and severity. However, they lost their significance under the influence of marital, living and occupational status when predicting the use of MHRU. CONCLUSION: Results confirm the existence of gender differences and highlight the importance of other factors for designing effective psychosocial services that are tailor-made to the patients' needs.