Sex and gender differences in schizophrenic psychoses—a critical review

  • Anita Riecher-Rössler
  • Surina Butler
  • Jayashri Kulkarni
Original Article


Many sex and gender differences in schizophrenic psychoses have been reported, but few have been soundly replicated. A stable finding is the later age of onset in women compared to men. Gender differences in symptomatology, comorbidity, and neurocognition seem to reflect findings in the general population. There is increasing evidence for estrogens being psychoprotective in women and for hypothalamic–pituitary–gonadal dysfunction in both sexes.

More methodologically sound, longitudinal, multi-domain, interdisciplinary research investigating both sex (biological) and gender (psychosocial) factors is required to better understand the different pathogenesis and etiologies of schizophrenic psychoses in women and men, thereby leading to better tailored treatments and improved outcomes.


Schizophrenia Psychosis Sex Gender Symptoms Risk Course Estrogens Prolactin 



We thank Claudine Pfister, MA, for her help in the preparation of the manuscript.


This research did not receive any specific grants or funding.


  1. Abel KM, Drake R, Goldstein JM (2010) Sex differences in schizophrenia. Int Rev Psychiatry 22(5):417–428. PubMedCrossRefGoogle Scholar
  2. Akhondzadeh S, Rezaei F, Larijani B, Nejatisafa AA, Kashani L, Abbasi SH (2006) Correlation between testosterone, gonadotropins and prolactin and severity of negative symptoms in male patients with chronic schizophrenia. Schizophr Res 84(2-3):405–410. PubMedCrossRefGoogle Scholar
  3. Albert K, Pruessner J, Newhouse P (2015) Estradiol levels modulate brain activity and negative responses to psychosocial stress across the menstrual cycle. Psychoneuroendocrinology 59:14–24. PubMedPubMedCentralCrossRefGoogle Scholar
  4. Aleman A, Kahn RS, Selten JP (2003) Sex differences in the risk of schizophrenia: evidence from meta-analysis. Arch Gen Psychiatry 60(6):565–571. PubMedCrossRefGoogle Scholar
  5. Arendt M, Rosenberg R, Foldager L, Perto G, Munk-Jorgensen P (2005) Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases. Br J Psychiatry 187:510–515. PubMedCrossRefGoogle Scholar
  6. Ayesa-Arriola R, Rodriguez-Sanchez JM, Gomez-Ruiz E, Roiz-Santiáñez R, Reeves LL, Crespo-Facorro B (2014) No sex differences in neuropsychological performance in first episode psychosis patients. Prog Neuro-Psychopharmacol Biol Psychiatry 48(Supplement C):149–154. CrossRefGoogle Scholar
  7. Ayhan Y, McFarland R, Pletnikov MV (2016) Animal models of gene–environment interaction in schizophrenia: a dimensional perspective. Prog Neurobiol 136:1–27. PubMedCrossRefGoogle Scholar
  8. Baldwin CH, Srivastava LK (2015) Can the neurodevelopmental theory account for sex differences in schizophrenia across the life span? J Psychiatry Neurosci 40(2):75–77PubMedPubMedCentralGoogle Scholar
  9. Barajas A, Ochoa S, Obiols JE, Lalucat-Jo L (2015) Gender differences in individuals at high-risk of psychosis: a comprehensive literature review. Sci World J 2015:430735. CrossRefGoogle Scholar
  10. Barker-Collo S, Read J (2011) The roles of gender and coping styles in the relationship between child abuse and the SCL90-R subscales ‘psychoticism’ and ‘paranoid ideation’. NZ J Psychol 40:28–38Google Scholar
  11. Bertani M, Lasalvia A, Bonetto C, Tosato S, Cristofalo D, Bissoli S, De Santi K, Mazzoncini R, Lazzarotto L, Santi M, Sale A, Scalabrin D, Abate M, Tansella M, Rugger M (2012) The influence of gender on clinical and social characteristics of patients at psychosis onset: a report from the Psychosis Incident Cohort Outcome Study (PICOS). Psychol Med 42(4):769–780. PubMedCrossRefGoogle Scholar
  12. Bora E, Fornito A, Radua J, Walterfang M, Seal M, Wood SJ, Yucel M, Velakoulis D, Pantelis C (2011) Neuroanatomical abnormalities in schizophrenia: a multimodal voxelwise meta-analysis and meta-regression analysis. Schizophr Res 127(1-3):46–57. PubMedCrossRefGoogle Scholar
  13. Boss L, Kang DH, Marcus M, Bergstrom N (2014) Endogenous sex hormones and cognitive function in older adults: a systematic review. West J Nurs Res 36(3):388–426. PubMedCrossRefGoogle Scholar
  14. Brekke JS, Nakagami E (2010) The relevance of neurocognition and social cognition for outcome and recovery in schizophrenia. Neurocognition and social cognition in schizophrenia patients. Basic concepts and treatment. Karger, BaselGoogle Scholar
  15. Bugra H, Studerus E, Rapp C, Tamagni C, Aston J, Borgwardt S, Riecher-Rössler A (2013) Cannabis use and cognitive functions in at-risk mental state and first episode psychosis. Psychopharmacology 230(2):299–308. PubMedCrossRefGoogle Scholar
  16. Bundy H, Stahl D, MacCabe JH (2011) A systematic review and meta-analysis of the fertility of patients with schizophrenia and their unaffected relatives. Acta Psychiatr Scand 123(2):98–106. PubMedCrossRefGoogle Scholar
  17. Cahill L (2006) Why sex matters for neuroscience. Nat Rev Neurosci 7(6):477–484. PubMedCrossRefGoogle Scholar
  18. Cannon TD (2015) How schizophrenia develops: cognitive and brain mechanisms underlying onset of psychosis. Trends Cogn Sci 19(12):744–756. PubMedPubMedCentralCrossRefGoogle Scholar
  19. Canuso CM, Pandina G (2007) Gender and schizophrenia. Psychopharmacol Bull 40(4):178–190PubMedGoogle Scholar
  20. Carlson LE, Sherwin BB (1999) Relationships among cortisol (CRT), dehydroepiandrosterone-sulfate (DHEAS), and memory in a longitudinal study of healthy elderly men and women. Neurobiol Aging 20(3):315–324. PubMedCrossRefGoogle Scholar
  21. Carter CS, Barch DM, Gur R, Gur R, Pinkham A, Ochsner K (2009) CNTRICS final task selection: social cognitive and affective neuroscience-based measures. Schizophr Bull 35(1):153–162. PubMedCrossRefGoogle Scholar
  22. Cascio MT, Cella M, Preti A, Meneghelli A, Cocchi A (2012) Gender and duration of untreated psychosis: a systematic review and meta-analysis. Early Interv Psychiatry 6(2):115–127. PubMedCrossRefGoogle Scholar
  23. Chase KA, Rosen C, Rubin LH, Feiner B, Bodapati AS, Gin H, Hu E, Sharma RP (2015) Evidence of a sex-dependent restrictive epigenome in schizophrenia. J Psychiatr Res 65:87–94. PubMedPubMedCentralCrossRefGoogle Scholar
  24. Cotton SM, Lambert M, Schimmelmann BG, Foley DL, Morley KI, McGorry PD, Conus P (2009) Gender differences in premorbid, entry, treatment, and outcome characteristics in a treated epidemiological sample of 661 patients with first episode psychosis. Schizophr Res 114(1-3):17–24. PubMedCrossRefGoogle Scholar
  25. Crocker CE, Tibbo PG (2017) The interaction of gender and cannabis in early phase psychosis. Schizophr Res.
  26. Cuesta MJ, Peralta V (2008) Current psychopathological issues in psychosis: towards a phenome-wide scanning approach. Schizophr Bull 34(4):587–590. PubMedPubMedCentralCrossRefGoogle Scholar
  27. Danaher H, Allott K, Killackey E, Hester R, Cotton S (2017) An examination of sex differences in neurocognition and social cognition in first-episode psychosis. Psychiatry Res 259:36–43. PubMedCrossRefGoogle Scholar
  28. Davidson M, Galderisi S, Weiser M, Werbeloff N, Fleischhacker WW, Keefe RS, Boter H, Keet IP, Prelipceanu D, Rybakowski JK, Libiger J, Hummer M, Dollfus S, Lopez-Ibor JJ, Hranov LG, Gaebel W, Peuskens J, Lindefors N, Riecher-Rössler A, Kahn RS (2009) Cognitive effects of antipsychotic drugs in first-episode schizophrenia and schizophreniform disorder: a randomized, open-label clinical trial (EUFEST). Am J Psychiatry 166(6):675–682. PubMedCrossRefGoogle Scholar
  29. van der Werf M, Hanssen M, Köhler S, Verkaaik M, Verhey FR, Investigators R, van Winkel R, van Os J, Allardyce J (2014) Systematic review and collaborative recalculation of 133,693 incident cases of schizophrenia. Psychol Med 44(1):9–16. PubMedCrossRefGoogle Scholar
  30. Di Forti M, Sallis H, Allegri F, Trotta A, Ferraro L, Stilo SA, Marconi A, La Cascia C, Reis Marques T, Pariante C, Dazzan P, Mondelli V, Paparelli A, Kolliakou A, Prata D, Gaughran F, David AS, Morgan C, Stahl D, Khondoker M, MacCabe JH, Murray RM (2014) Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. Schizophr Bull 40(6):1509–1517. PubMedCrossRefGoogle Scholar
  31. Duggal HS, Muddasani S, Keshavan MS (2005) Insular volumes in first-episode schizophrenia: gender effect. Schizophr Res 73(1):113–120. PubMedCrossRefGoogle Scholar
  32. Egloff L, Lenz C, Studerus E, Harrisberger F, Simieskova R, Schmidt A, Huber C, Simon A, Lang UE, Riecher-Rössler A, Borgwardt S (2018) Sexually dimorphic subcortical brain volumes in emerging psychosis. Schizophr Res. Google Scholar
  33. Eranti SV, MacCabe JH, Bundy H, Murray RM (2013) Gender difference in age at onset of schizophrenia: a meta-analysis. Psychol Med 43(1):155–167. PubMedCrossRefGoogle Scholar
  34. Esterberg ML, Trotman HD, Holtzman C, Compton MT, Walker EF (2010) The impact of a family history of psychosis on age-at-onset and positive and negative symptoms of schizophrenia: a meta-analysis. Schizophr Res 120(1-3):121–130. PubMedCrossRefGoogle Scholar
  35. EU Report on Promoting Gender Equality in Mental Health and Clinical Research (2016/2096(INI)) by the Committee on Women’s Rights and Gender Equality (2016).
  36. Falkenburg J, Tracy DK (2014) Sex and schizophrenia: a review of gender differences. Psychosis 6(1):61–69. CrossRefGoogle Scholar
  37. Fatouros-Bergman H, Cervenka S, Flyckt L, Edman G, Farde L (2014) Meta-analysis of cognitive performance in drug-naive patients with schizophrenia. Schizophr Res 158(1-3):156–162. PubMedCrossRefGoogle Scholar
  38. Ferrari M, Flora N, Anderson KK, Haughton A, Tuck A, Archie S, Kidd S, McKenzie K, Team ACEP (2016) Gender differences in pathways to care for early psychosis. Early Interv Psychiatry. doi:
  39. Filatova S, Marttila R, Koivumaa-Honkanen H, Nordstrom T, Veijola J, Maki P, Khandaker GM, Isohanni M, Jaaskelainen E, Moilanen K, Miettunen J (2017) A comparison of the cumulative incidence and early risk factors for psychotic disorder in young adults in the Northern Finland Birth Cohorts 1966 and 1986. Epidemiol Psychiatr Sci 26(3):314–324. PubMedCrossRefGoogle Scholar
  40. Fischer B, Gleason C, Asthana S (2014) Effects of hormone therapy on cognition and mood. Fertility and Sterility 101 (4):898–904.PubMedPubMedCentralCrossRefGoogle Scholar
  41. Frederikse M, Lu A, Aylward E, Barta P, Sharma T, Pearlson G (2000) Sex differences in inferior parietal lobule volume in schizophrenia. Am J Psychiatry 157(3):422–427. PubMedCrossRefGoogle Scholar
  42. Fridgen GJ, Aston J, Gschwandtner U, Pflueger M, Zimmermann R, Studerus E, Stieglitz RD, Riecher-Rössler A (2013) Help-seeking and pathways to care in the early stages of psychosis. Soc Psychiatry Psychiatr Epidemiol 48:1033–1043. PubMedCrossRefGoogle Scholar
  43. Fusar-Poli P, Bonoldi I, Yung AR, Borgwardt S, Kempton MJ, Valmaggia L, Barale F, Caverzasi E, McGuire P (2012a) Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 69(3):220–229. PubMedCrossRefGoogle Scholar
  44. Fusar-Poli P, McGuire P, Borgwardt S (2012b) Mapping prodromal psychosis: a critical review of neuroimaging studies. Eur Psychiatry 27(3):181–191. PubMedCrossRefGoogle Scholar
  45. Fusar-Poli P, Rutigliano G, Stahl D, Davies C, Bonoldi I, Reilly T, McGuire P (2017) Development and validation of a clinically based risk calculator for the transdiagnostic prediction of psychosis. JAMA Psychiatry 74(5):493–500. PubMedPubMedCentralCrossRefGoogle Scholar
  46. Galderisi S, Bucci P, Ucok A, Peuskens J (2012) No gender differences in social outcome in patients suffering from schizophrenia. Eur Psychiatry 27(6):406–408. PubMedCrossRefGoogle Scholar
  47. Garcia M, Montalvo I, Creus M, Cabezas A, Sole M, Algora MJ, Moreno I, Gutierrez-Zotes A, Labad J (2016) Sex differences in the effect of childhood trauma on the clinical expression of early psychosis. Compr Psychiatry 68:86–96. PubMedCrossRefGoogle Scholar
  48. Gibson LE, Anglin DM, Klugman JT, Reeves LE, Fineberg AM, Maxwell SD, Kerns CM, Ellman LM (2014) Stress sensitivity mediates the relationship between traumatic life events and attenuated positive psychotic symptoms differentially by gender in a college population sample. J Psychiatr Res 53(Supplement C):111–118. PubMedCrossRefGoogle Scholar
  49. Gibson LE, Alloy LB, Ellman LM (2016) Trauma and the psychosis spectrum: a review of symptom specificity and explanatory mechanisms. Clin Psychol Rev 49:92–105. PubMedPubMedCentralCrossRefGoogle Scholar
  50. Gillies GE, McArthur S (2010) Estrogen actions in the brain and the basis for differential action in men and women: a case for sex-specific medicines. Pharmacol Rev 62(2):155–198. PubMedPubMedCentralCrossRefGoogle Scholar
  51. Goel N, Workman JL, Lee TT, Innala L, Viau V (2014) Sex differences in the HPA axis. Compr Physiol 4(3):1121–1155. PubMedCrossRefGoogle Scholar
  52. Gogos A, Sbisa AM, Sun J, Gibbons A, Udawela M, Dean B (2015) A role for estrogen in schizophrenia: clinical and preclinical findings. Int J Endocrinol 2015:16. CrossRefGoogle Scholar
  53. Goldstein JM, Seidman LJ, O'Brien LM, Horton NJ, Kennedy DN, Makris N, Caviness VS Jr, Faraone SV, Tsuang MT (2002) Impact of normal sexual dimorphisms on sex differences in structural brain abnormalities in schizophrenia assessed by magnetic resonance imaging. Arch Gen Psychiatry 59(2):154–164PubMedCrossRefGoogle Scholar
  54. Goldstein JM, Seidman LJ, Makris N, Ahern T, O'Brien LM, Caviness VS Jr, Kennedy DN, Faraone SV, Tsuang MT (2007) Hypothalamic abnormalities in schizophrenia: sex effects and genetic vulnerability. Biol Psychiatry 61(8):935–945. PubMedCrossRefGoogle Scholar
  55. Goldstein JM, Jerram M, Abbs B, Whitfield-Gabrieli S, Makris N (2010) Sex differences in stress response circuitry activation dependent on female hormonal cycle. J Neurosci 30(2):431–438. PubMedPubMedCentralCrossRefGoogle Scholar
  56. Goldstein JM, Cherkerzian S, Seidman LJ, Petryshen TL, Fitzmaurice G, Tsuang MT, Buka SL (2011) Sex-specific rates of transmission of psychosis in the New England high-risk family study. Schizophr Res 128(1-3):150–155. PubMedPubMedCentralCrossRefGoogle Scholar
  57. Goldstein JM, Cherkerzian S, Tsuang MT, Petryshen TL (2013) Sex differences in the genetic risk for schizophrenia: history of the evidence for sex-specific and sex-dependent effects. Am J Med Genet B Neuropsychiatr Genet 162B(7):698–710. PubMedCrossRefGoogle Scholar
  58. Gonzalez-Blanco L, Greenhalgh AM, Garcia-Rizo C, Fernandez-Egea E, Miller BJ, Kirkpatrick B (2016) Prolactin concentrations in antipsychotic-naive patients with schizophrenia and related disorders: a meta-analysis. Schizophr Res 174(1-3):156–160. PubMedCrossRefGoogle Scholar
  59. González-Rodríguez A, Studerus E, Spitz A, Bugra H, Aston J, Borgwardt S, Rapp C, Riecher-Rössler A (2014) Gender differences in the psychopathology of emerging psychosis. Isr J Psychiatry Relat Sci 51(2):85–93PubMedGoogle Scholar
  60. Gur RE, Cowell PE, Latshaw A, Turetsky BI, Grossman RI, Arnold SE, Bilker WB, Gur RC (2000) Reduced dorsal and orbital prefrontal gray matter volumes in schizophrenia. Arch Gen Psychiatry 57(8):761–768PubMedCrossRefGoogle Scholar
  61. Gur RE, Kohler C, Turetsky BI, Siegel SJ, Kanes SJ, Bilker WB, Brennan AR, Gur RC (2004) A sexually dimorphic ratio of orbitofrontal to amygdala volume is altered in schizophrenia. Biol Psychiatry 55(5):512–517. PubMedCrossRefGoogle Scholar
  62. Haarmans M (2015) Improving our science in psychosis research with a sex- and gender-based analysis. In: Sáenz-Herrero M (ed) Psychopathology in women: incorporating gender perspective into descriptive psychopathology. Springer International Publishing, Cham, pp 83–110. CrossRefGoogle Scholar
  63. Häfner H, Riecher A, Maurer K, Löffler W, Munk-Jorgensen P, Stromgren E (1989) How does gender influence age at first hospitalization for schizophrenia? A transnational case register study. Psychol Med 19(4):903–918PubMedCrossRefGoogle Scholar
  64. Häfner H, Riecher-Rössler A, Fätkenheuer B, Hambrecht M, Löffler W, An der Heiden W (1991a) Sex differences in schizophrenia. Psychiatr Fenn 22:123–156Google Scholar
  65. Häfner H, Riecher A, Maurer K, Fatkenheuer B, Löffler W, an der Heiden W, Munk-Jorgensen P, Stromgren E (1991b) [Sex differences in schizophrenic diseases] ([Sex differences in schizophrenic diseases]). Fortschr Neurol Psychiatr 59(9):343–360PubMedCrossRefGoogle Scholar
  66. Häfner H, Riecher-Rössler A, Maurer K, Fatkenheuer B, Löffler W (1992) First onset and early symptomatology of schizophrenia. A chapter of epidemiological and neurobiological research into age and sex differences. Eur Arch Psychiatry Clin Neurosci 242(2-3):109–118PubMedCrossRefGoogle Scholar
  67. Häfner H, Maurer K, Löffler W, Riecher-Rössler A (1993) The influence of age and sex on the onset and early course of schizophrenia. Br J Psychiatry 162:80–86PubMedCrossRefGoogle Scholar
  68. Häfner H, Maurer K, Löffler W, Fatkenheuer B, an der Heiden W, Riecher-Rössler A, Behrens S, Gattaz WF (1994) The epidemiology of early schizophrenia. Influence of age and gender on onset and early course. Br J Psychiatry Suppl (23):29-38Google Scholar
  69. Heidari S, Babor TF, De Castro P, Tort S, Curno M (2016) Sex and gender equity in research: rationale for the SAGER guidelines and recommended use. Res Integr Peer Rev 1(1):2. PubMedPubMedCentralCrossRefGoogle Scholar
  70. Heitz U, Papmeyer M, Menghini-Müller S, Egloff L, Ittig S, Navarra A, Studerus E, Riecher-Rössler A (2017) Gender differences in first self-perceived signs and symptoms in patients with an at-risk mental state and first episode psychosis. Early Interv Psychiatry. doi:
  71. Heringa SM, Begemann MJ, Goverde AJ, Sommer IE (2015) Sex hormones and oxytocin augmentation strategies in schizophrenia: a quantitative review. Schizophr Res 168(3):603–613. PubMedCrossRefGoogle Scholar
  72. Herting MM, Maxwell EC, Irvine C, Nagel BJ (2012) The impact of sex, puberty, and hormones on white matter microstructure in adolescents. Cereb Cortex 22(9):1979–1992. PubMedCrossRefGoogle Scholar
  73. Hill RA (2016) Sex differences in animal models of schizophrenia shed light on the underlying pathophysiology. Neurosci Biobehav Rev 67:41–56. PubMedCrossRefGoogle Scholar
  74. Höfer P, Lanzenberger R, Kasper S (2013) Testosterone in the brain: neuroimaging findings and the potential role for neuropsychopharmacology. Eur Neuropsychopharmacol 23(2):79–88. PubMedCrossRefGoogle Scholar
  75. Hoff AL, Wieneke M, Faustman WO, Horon R, Sakuma M, Blankfeld H, Espinoza S, DeLisi LE (1998) Sex differences in neuropsychological functioning of first-episode and chronically ill schizophrenic patients. Am J Psychiatry 155(10):1437–1439. PubMedCrossRefGoogle Scholar
  76. Hoff AL, Kremen WS, Wieneke MH, Lauriello J, Blankfeld HM, Faustman WO, Csernansky JG, Nordahl TE (2001) Association of estrogen levels with neuropsychological performance in women with schizophrenia. Am J Psychiatry 158(7):1134–1139PubMedCrossRefGoogle Scholar
  77. Holtzman CW, Larson MK, Addington J, Cadenhead K, Cannon TD, Cornblatt B, Heinssen R, McGlashan T, Perkins D, Seidman LJ, Tsuang M, Woods SW, Walker EF (2010) Poster: sex differences in symptom presentation in individuals at risk for psychosis. Schizophr Res 117(2):304–305. CrossRefGoogle Scholar
  78. Howard LM, Ehrlich AM, Gamlen F, Oram S (2017) Gender-neutral mental health research is sex and gender biased. Lancet Psychiatry 4(1):9–11. PubMedCrossRefGoogle Scholar
  79. Howes OD, Kapur S (2009) The dopamine hypothesis of schizophrenia: version III—the final common pathway. Schizophr Bull 35(3):549–562. PubMedPubMedCentralCrossRefGoogle Scholar
  80. Huber TJ, Tettenborn C, Leifke E, Emrich HM (2005) Sex hormones in psychotic men. Psychoneuroendocrinology 30(1):111–114. PubMedCrossRefGoogle Scholar
  81. Hui CL, Leung CM, Chang WC, Chan SK, Lee EH, Chen EY (2016) Examining gender difference in adult-onset psychosis in Hong Kong. Early Interv Psychiatry 10(4):324–333. PubMedCrossRefGoogle Scholar
  82. Ingalhalikar M, Smith A, Parker D, Satterthwaite TD, Elliott MA, Ruparel K, Hakonarson H, Gur RE, Gur RC, Verma R (2014) Sex differences in the structural connectome of the human brain. Proc Natl Acad Sci U S A 111(2):823–828. PubMedCrossRefGoogle Scholar
  83. Irani F, Seligman S, Kamath V, Kohler C, Gur RC (2012) A meta-analysis of emotion perception and functional outcomes in schizophrenia. Schizophr Res 137(1-3):203–211. PubMedPubMedCentralCrossRefGoogle Scholar
  84. Irle E, Lange C, Ruhleder M, Exner C, Siemerkus J, Weniger G (2011) Hippocampal size in women but not men with schizophrenia relates to disorder duration. Psychiatry Res 192(3):133–139. PubMedCrossRefGoogle Scholar
  85. Ittig S, Studerus E, Papmeyer M, Uttinger M, Koranyi S, Ramyead A, Riecher-Rössler A (2015) Sex differences in cognitive functioning in at-risk mental state for psychosis, first episode psychosis and healthy control subjects. Eur Psychiatry 30:242–250. PubMedCrossRefGoogle Scholar
  86. Ittig S, Studerus E, Heitz U, Menghini-Müller S, Beck K, Egloff L, Leanza L, Andreou C, Riecher-Rössler A (2017) Sex differences in prolactin levels in emerging psychosis: indication for enhanced stress reactivity in women. Schizophr Res 189:111–116.
  87. Jääskelainen E, Juola P, Hirvonen N, McGrath JJ, Saha S, Isohanni M, Veijola J, Miettunen J (2013) A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull 39(6):1296–1306. PubMedCrossRefGoogle Scholar
  88. Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 20:1–97PubMedCrossRefGoogle Scholar
  89. Jimenez JA, Mancini-Marie A, Lakis N, Rinaldi M, Mendrek A (2010) Disturbed sexual dimorphism of brain activation during mental rotation in schizophrenia. Schizophr Res 122(1-3):53–62. PubMedCrossRefGoogle Scholar
  90. Kelly DL, Rowland LM, Patchan KM, Sullivan K, Earl A, Raley H, Liu F, Feldman S, McMahon RP (2016) Schizophrenia clinical symptom differences in women vs. men with and without a history of childhood physical abuse. Child Adolesc Psychiatry Ment Health 10:5. PubMedPubMedCentralCrossRefGoogle Scholar
  91. Khan SS, Secades-Villa R, Okuda M, Wang S, Perez-Fuentes G, Kerridge BT, Blanco C (2013) Gender differences in cannabis use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions. Drug Alcohol Depend 130(1-3):101–108. PubMedCrossRefGoogle Scholar
  92. Kirkbride JB, Errazuriz A, Croudace TJ, Morgan C, Jackson D, Boydell J, Murray RM, Jones PB (2012) Incidence of schizophrenia and other psychoses in England, 1950–2009: a systematic review and meta-analyses. PLoS One 7(3):e31660. PubMedPubMedCentralCrossRefGoogle Scholar
  93. Koskinen J, Lohonen J, Koponen H, Isohanni M, Miettunen J (2010) Rate of cannabis use disorders in clinical samples of patients with schizophrenia: a meta-analysis. Schizophr Bull 36(6):1115–1130. PubMedCrossRefGoogle Scholar
  94. Koster A, Lajer M, Lindhardt A, Rosenbaum B (2008) Gender differences in first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 43(12):940–946. PubMedCrossRefGoogle Scholar
  95. Kotlicka-Antczak M, Pawelczyk T, Podgorski M, Zurner N, Karbownik MS, Pawelczyk A (2016) Polish individuals with an at-risk mental state: demographic and clinical characteristics. Early Interv Psychiatry.
  96. Kraan TC, Velthorst E, Themmen M, Valmaggia L, Kempton MJ, McGuire P, van Os J, Rutten BPF, Smit F, de Haan L, van der Gaag M (2018) Child maltreatment and clinical outcome in individuals at ultra-high risk for psychosis in the EU-GEI high risk study. Schizophr Bull 44(3):584-592. doi:
  97. Kring AM, Gordon AH (1998) Sex differences in emotion: expression, experience, and physiology. J Pers Soc Psychol 74(3):686–703. PubMedCrossRefGoogle Scholar
  98. Kudielka BM, Kirschbaum C (2005) Sex differences in HPA axis responses to stress: a review. Biol Psychol 69(1):113–132. PubMedCrossRefGoogle Scholar
  99. Kühl JOG, Laursen TM, Thorup A, Nordentoft M (2016) The incidence of schizophrenia and schizophrenia spectrum disorders in Denmark in the period 2000–2012. A register-based study. Schizophr Res 176(2-3):533–539. PubMedCrossRefGoogle Scholar
  100. Labad J, Stojanovic-Perez A, Montalvo I, Sole M, Cabezas A, Ortega L, Moreno I, Vilella E, Martorell L, Reynolds RM, Gutierrez-Zotes A (2015) Stress biomarkers as predictors of transition to psychosis in at-risk mental states: roles for cortisol, prolactin and albumin. J Psychiatr Res 60:163–169. PubMedCrossRefGoogle Scholar
  101. Lally J, Ajnakina O, Stubbs B, Williams HR, Colizzi M, Carra E, Fraietta S, Gardner-Sood P, Greenwood KE, Atakan Z, Mondelli V, Ismail K, Howes O, Taylor DM, Smith S, Hopkins D, Murray RM, Gaughran F (2017) Hyperprolactinaemia in first episode psychosis—a longitudinal assessment. Schizophr Res 189:117-125. doi:
  102. Lange EH, Nesvåg R, Ringen PA, Hartberg CB, Haukvik UK, Andreassen OA, Melle I, Agartz I (2014) One year follow-up of alcohol and illicit substance use in first-episode psychosis: does gender matter? Compr Psychiatry 55(2):274–282. PubMedCrossRefGoogle Scholar
  103. Large M, Sharma S, Compton MT, Slade T, Nielssen O (2011) Cannabis use and earlier onset of psychosis: a systematic meta-analysis. Arch Gen Psychiatry 68(6):555–561. PubMedCrossRefGoogle Scholar
  104. Lennartsson AK, Jonsdottir IH (2011) Prolactin in response to acute psychosocial stress in healthy men and women. Psychoneuroendocrinology 36(10):1530–1539. PubMedCrossRefGoogle Scholar
  105. Leung MDDA, Chue MRC, Psych DP (2000) Sex differences in schizophrenia, a review of the literature. Acta Psychiatr Scand 101(401):3–38. CrossRefGoogle Scholar
  106. Longenecker J, Genderson J, Dickinson D, Malley J, Elvevåg B, Weinberger DR, Gold J (2010) Where have all the women gone?: participant gender in epidemiological and non-epidemiological research of schizophrenia. Schizophr Res 119(1):240–245. PubMedPubMedCentralCrossRefGoogle Scholar
  107. Low M (2016) Chapter 7—neuroendocrinology. In: Melmed S, Polonsky K, Laresen P, Kronenberg H (eds) Williams textbook of endocrinology, 13th edn. W.B. Saunders Co, Philadelphia, pp 109–175. CrossRefGoogle Scholar
  108. MacMaster FP, Keshavan M, Mirza Y, Carrey N, Upadhyaya AR, El-Sheikh R, Buhagiar CJ, Taormina SP, Boyd C, Lynch M, Rose M, Ivey J, Moore GJ, Rosenberg DR (2007) Development and sexual dimorphism of the pituitary gland. Life Sci 80(10):940–944. PubMedCrossRefGoogle Scholar
  109. Maki PM, Dumas J (2009) Mechanisms of action of estrogen in the brain: insights from human neuroimaging and psychopharmacologic studies. Semin Reprod Med 27(3):250–259. PubMedPubMedCentralCrossRefGoogle Scholar
  110. Marchbanks RM, Ryan M, Day IN, Owen M, McGuffin P, Whatley SA (2003) A mitochondrial DNA sequence variant associated with schizophrenia and oxidative stress. Schizophr Res 65(1):33–38PubMedCrossRefGoogle Scholar
  111. Maric N, Krabbendam L, Vollebergh W, de Graaf R, van Os J (2003) Sex differences in symptoms of psychosis in a non-selected, general population sample. Schizophr Res 63(1-2):89–95PubMedCrossRefGoogle Scholar
  112. Maric N, Popovic V, Jasovic-Gasic M, Pilipovic N, van Os J (2005) Cumulative exposure to estrogen and psychosis: a peak bone mass, case-control study in first-episode psychosis. Schizophr Res 73(2-3):351–355. PubMedCrossRefGoogle Scholar
  113. Maric NP, Raballo A, Rojnic Kuzman M, Andric Petrovic S, Klosterkötter J, Riecher-Rössler A (2017) European status and perspectives on early detection and intervention in at-risk mental state and first episode psychosis: viewpoint from the EPA section for prevention of mental disorders. Eur Psychiatry 46(Supplement C):48–50. PubMedCrossRefGoogle Scholar
  114. Markham JA (2012) Sex steroids and schizophrenia. Rev Endocr Metab Disord 13(3):187–207. PubMedCrossRefGoogle Scholar
  115. Mayo D, Corey S, Kelly LH, Yohannes S, Youngquist AL, Stuart BK, Niendam TA, Loewy RL (2017) The role of trauma and stressful life events among individuals at clinical high risk for psychosis: a review. Front Psychiatry 8:55. PubMedPubMedCentralCrossRefGoogle Scholar
  116. McCarthy MM (2008) Estradiol and the developing brain. Physiol Rev 88(1):91–124. PubMedPubMedCentralCrossRefGoogle Scholar
  117. McCarthy MM (2015) Incorporating sex as a variable in preclinical neuropsychiatric research. Schizophr Bull 41(5):1016–1020. PubMedPubMedCentralCrossRefGoogle Scholar
  118. McEwen BS, Milner TA (2017) Understanding the broad influence of sex hormones and sex differences in the brain. J Neurosci Res 95(1-2):24–39. PubMedPubMedCentralCrossRefGoogle Scholar
  119. McGrath J, Saha S, Chant D, Welham J (2008) Schizophrenia: a concise overview of incidence, prevalence, and mortality. Epidemiol Rev 30:67–76. PubMedCrossRefPubMedCentralGoogle Scholar
  120. Melcangi RC, Panzica G, Garcia-Segura LM (2011) Neuroactive steroids: focus on human brain. Neuroscience 191:1–5. PubMedCrossRefGoogle Scholar
  121. Mendrek A (2007) Reversal of normal cerebral sexual dimorphism in schizophrenia: evidence and speculations. Med Hypotheses 69(4):896–902. PubMedCrossRefGoogle Scholar
  122. Mendrek A, Stip E (2011) Sexual dimorphism in schizophrenia: is there a need for gender-based protocols? Expert Rev Neurother 11(7):951–959. PubMedCrossRefGoogle Scholar
  123. Mendrek A, Mancini-Marie A, Fahim C, Stip E (2007) Sex differences in the cerebral function associated with processing of aversive stimuli by schizophrenia patients. Aust N Z J Psychiatry 41(2):136–141. PubMedCrossRefGoogle Scholar
  124. Menghini-Müller S, Studerus E, Heitz U, Egloff L, Ittig S, Riecher-Rössler A (2016) Gender differences in the symptomatology of patients at-risk for psychosis—results from the EU-GEI study. In: 5th Biennial SIRS Conference, Florence, Italy, 2–6 April 2016. vol 2. npj Schizophrenia, pp 19–20Google Scholar
  125. Moore L, Kyaw M, Vercammen A, Lenroot R, Kulkarni J, Curtis J, O’Donnell M, Carr VJ, Shannon Weickert C, Weickert TW (2013) Serum testosterone levels are related to cognitive function in men with schizophrenia. Psychoneuroendocrinology 38(9):1717–1728. PubMedCrossRefGoogle Scholar
  126. Morris RW, Purves-Tyson TD, Weickert CS, Rothmond D, Lenroot R, Weickert TW (2015) Testosterone and reward prediction-errors in healthy men and men with schizophrenia. Schizophr Res 168(3):649-660. doi:
  127. Murray RM, Quigley H, Quattrone D, Englund A, Di Forti M (2016) Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis. World Psychiatry 15(3):195–204. PubMedPubMedCentralCrossRefGoogle Scholar
  128. Myin-Germeys I, Krabbendam L, Delespaul PA, van Os J (2004) Sex differences in emotional reactivity to daily life stress in psychosis. J Clin Psychiatry 65(6):805–809PubMedCrossRefGoogle Scholar
  129. Narr KL, Bilder RM, Kim S, Thompson PM, Szeszko P, Robinson D, Luders E, Toga AW (2004) Abnormal gyral complexity in first-episode schizophrenia. Biol Psychiatry 55(8):859–867. PubMedCrossRefGoogle Scholar
  130. Newhouse P, Albert K (2015) Estrogen, stress, and depression: a neurocognitive model. JAMA Psychiatry 72(7):727–729. PubMedCrossRefGoogle Scholar
  131. Newman SC, Bland RC, Thompson AH (2012) Long-term course and outcome in schizophrenia: a 34-year follow-up study in Alberta, Canada. Psychol Med 42(10):2137–2143. PubMedCrossRefGoogle Scholar
  132. Ngun TC, Ghahramani N, Sanchez FJ, Bocklandt S, Vilain E (2011) The genetics of sex differences in brain and behavior. Front Neuroendocrinol 32(2):227–246. PubMedCrossRefGoogle Scholar
  133. Nordholm D, Krogh J, Mondelli V, Dazzan P, Pariante C, Nordentoft M (2013) Pituitary gland volume in patients with schizophrenia, subjects at ultra high-risk of developing psychosis and healthy controls: a systematic review and meta-analysis. Psychoneuroendocrinology 38(11):2394–2404. PubMedCrossRefGoogle Scholar
  134. Novick D, Haro JM, Hong J, Brugnoli R, Lepine JP, Bertsch J, Karagianis J, Dossenbach M, Alvarez E (2012) Regional differences in treatment response and three year course of schizophrenia across the world. J Psychiatr Res 46(7):856–864. PubMedCrossRefGoogle Scholar
  135. Nunez C, Ochoa S, Huerta-Ramos E, Banos I, Barajas A, Dolz M, Sanchez B, Del Cacho N, Group G, Usall J (2016) Differential effects of sex on substance use between first episode psychosis patients and healthy people. Compr Psychiatry 69:169–178. PubMedCrossRefGoogle Scholar
  136. O’Leary DS, Flaum M, Kesler ML, Flashman LA, Arndt S, Andreasen NC (2000) Cognitive correlates of the negative, disorganized, and psychotic symptom dimensions of schizophrenia. J Neuropsychiatr Clin Neurosci 12(1):4–15. CrossRefGoogle Scholar
  137. Ochoa S, Usall J, Cobo J, Labad X, Kulkarni J (2012) Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review. Schizophr Res Treat 2012:916198. CrossRefGoogle Scholar
  138. van Os J, EU-GEI-Study-Group (2014) European Network of National Networks studying Gene–Environment Interactions in Schizophrenia: identifying gene–environment interactions in schizophrenia: contemporary challenges for integrated, large-scale investigations. Schizophr Bull 40(4):729–736. PubMedCrossRefGoogle Scholar
  139. Petrikis P, Tigas S, Tzallas AT, Archimandriti DT, Skapinakis P, Mavreas V (2016) Prolactin levels in drug-naive patients with schizophrenia and other psychotic disorders. Int J Psychiatry Clin Pract 20(3):165–169. PubMedCrossRefGoogle Scholar
  140. Pinkham AE, Kelsven S, Kouros C, Harvey PD, Penn DL (2017) The effect of age, race, and sex on social cognitive performance in individuals with schizophrenia. J Nerv Ment Dis 205(5):346–352. PubMedPubMedCentralCrossRefGoogle Scholar
  141. Pompili A, Arnone B, Gasbarri A (2012) Estrogens and memory in physiological and neuropathological conditions. Psychoneuroendocrinology 37(9):1379–1396. PubMedCrossRefGoogle Scholar
  142. Pruessner M, Lepage M, Collins DL, Pruessner JC, Joober R, Malla AK (2015) Reduced hippocampal volume and hypothalamus-pituitary-adrenal axis function in first episode psychosis: evidence for sex differences. Neuroimage Clin 7:195–202. PubMedCrossRefGoogle Scholar
  143. Pruessner M, Faridi K, Shah J, Rabinovitch M, Iyer S, Abadi S, Pawliuk N, Joober R, Malla AK (2017) The Clinic for Assessment of Youth at Risk (CAYR): 10 years of service delivery and research targeting the prevention of psychosis in Montreal, Canada. Early Interv Psychiatry 11(2):177–184. PubMedCrossRefGoogle Scholar
  144. Resnick S, Driscoll I (2008) Sex differences in brain aging and Alzheimer’s disease. In: Becker J, Berkley K, Geary N (eds) Sex differences in the brain: from genes to behavior. Oxford University Press, Oxford, pp 427–454Google Scholar
  145. Riecher-Rössler A (1994) Die Spätschizophrenie - eine valide Entität? Eine empirische Studie zu Risikofaktoren, Krankheitsbild und Verlauf. Habilitationsschrift. Fakultät für klinische Medizin Mannheim, Universität Heidelberg. HabilitationsschriftGoogle Scholar
  146. Riecher-Rössler A (2003) Oestrogens and schizophrenia. Curr Opin Psychiatry 16:187–192CrossRefGoogle Scholar
  147. Riecher-Rössler A (2005) Estrogens and schizophrenia. In: Bergemann N, Riecher-Rössler A (eds) Estrogen effects in psychiatric disorders. Springer, Wien, pp 31–52CrossRefGoogle Scholar
  148. Riecher-Rössler A (2009) Psychotic disorders and menopause: the untold story. The menopausal transition—interface between gynecology and psychiatry. Karger, BaselGoogle Scholar
  149. Riecher-Rössler A (2017) Oestrogens, prolactin, hypothalamic–pituitary–gonadal axis, and schizophrenic psychoses. Lancet Psychiatry 4(1):63–72. PubMedCrossRefGoogle Scholar
  150. Riecher-Rössler A (in print) Vulnerability and protective factors for mental health: a rereading in gender perspective. In: Tarricone I, Riecher-Rössler A (eds) Health and gender. Resilience factors in the health of women in contemporary society. Springer International Publishing AG, ChamGoogle Scholar
  151. Riecher-Rössler A, Häfner H (1993) Schizophrenia and oestrogens—is there an association? Eur Arch Psychiatry Clin Neurosci 242(6):323–328PubMedCrossRefGoogle Scholar
  152. Riecher-Rössler A, Häfner H (2000) Gender aspects in schizophrenia: bridging the border between social and biological psychiatry. Acta Psychiatr Scand Suppl 407:58–62CrossRefGoogle Scholar
  153. Riecher-Rössler A, Kulkarni J (2011) Estrogens and gonadal function in schizophrenia and related psychoses. Curr Top Behav Neurosci 8:155–171. PubMedCrossRefGoogle Scholar
  154. Riecher-Rössler A, McGorry P (2016) Early detection and intervention in psychosis. State of the art and future perspectives. Key Issues Ment Health, vol 181. Karger, BaselCrossRefGoogle Scholar
  155. Riecher-Rössler A, Rössler W (1998) The course of schizophrenic psychoses: what do we really know? A selective review from an epidemiological perspective. Eur Arch Psychiatry Clin Neurosci 248(4):189–202PubMedCrossRefGoogle Scholar
  156. Riecher-Rössler A, Studerus E (2016) High time for a paradigm shift in psychiatry. World Psychiatry 15(2):131–133. PubMedPubMedCentralCrossRefGoogle Scholar
  157. Riecher-Rössler A, Studerus E (2017) Prediction of conversion to psychosis in individuals with an at-risk mental state: a brief update on recent developments. Curr Opin Psychiatry 30(3):209–219. PubMedCrossRefGoogle Scholar
  158. Riecher-Rössler A, Häfner H, Stumbaum M, Maurer K, Schmidt R (1994) Can estradiol modulate schizophrenic symptomatology? Schizophr Bull 20(1):203–214PubMedCrossRefGoogle Scholar
  159. Riecher-Rössler A, Löffler W, Munk-Jorgensen P (1997) What do we really know about late-onset schizophrenia? Eur Arch Psychiatry Clin Neurosci 247(4):195–208PubMedCrossRefGoogle Scholar
  160. Riecher-Rössler A, Pflueger MO, Aston J, Borgwardt SJ, Brewer WJ, Gschwandtner U, Stieglitz RD (2009) Efficacy of using cognitive status in predicting psychosis: a 7-year follow-up. Biol Psychiatry 66(11):1023–1030. PubMedCrossRefGoogle Scholar
  161. Riecher-Rössler A, Pflueger MO, Borgwardt S (2010) Schizophrenia in women. In: Kohen D (ed) Oxford textbook of women and mental health. Oxford University Press, Oxford, pp 102–114Google Scholar
  162. Riecher-Rössler A, Rybakowski JK, Pflueger MO, Beyrau R, Kahn RS, Malik P, Fleischhacker WW (2013) Hyperprolactinemia in antipsychotic-naive patients with first-episode psychosis. Psychol Med 43(12):2571–2582. PubMedCrossRefGoogle Scholar
  163. Rietdijk J, Ising HK, Dragt S, Klaassen R, Nieman D, Wunderink L, Cuijpers P, Linszen D, van der Gaag M (2013) Depression and social anxiety in help-seeking patients with an ultra-high risk for developing psychosis. Psychiatry Res 209(3):309–313. PubMedCrossRefGoogle Scholar
  164. Rietschel L, Lambert M, Karow A, Zink M, Muller H, Heinz A, de Millas W, Janssen B, Gaebel W, Schneider F, Naber D, Juckel G, Kruger-Ozgurdal S, Wobrock T, Wagner M, Maier W, Klosterkotter J, Bechdolf A, group Ps (2017) Clinical high risk for psychosis: gender differences in symptoms and social functioning. Early Interv Psychiatry 11(4):306–313. PubMedCrossRefGoogle Scholar
  165. van Rijn S, Aleman A, de Sonneville L, Sprong M, Ziermans T, Schothorst P, van Engeland H, Swaab H (2011) Neuroendocrine markers of high risk for psychosis: salivary testosterone in adolescent boys with prodromal symptoms. Psychol Med 41(9):1815–1822. PubMedCrossRefGoogle Scholar
  166. Ritsner MS (2011) The clinical and therapeutic potentials of dehydroepiandrosterone and pregnenolone in schizophrenia. Neuroscience 191:91–100. PubMedCrossRefGoogle Scholar
  167. Rubin LH, Carter CS, Drogos L, Pournajafi-Nazarloo H, Sweeney JA, Maki PM (2010) Peripheral oxytocin is associated with reduced symptom severity in schizophrenia. Schizophr Res 124(1-3):13–21. PubMedPubMedCentralCrossRefGoogle Scholar
  168. Saha S, Chant D, Welham J, McGrath J (2005) A systematic review of the prevalence of schizophrenia. PLoS Med 2(5):e141. PubMedPubMedCentralCrossRefGoogle Scholar
  169. Salokangas RK, Stengard E (1990) Gender and short-term outcome in schizophrenia. Schizophr Res 3(5-6):333–345PubMedCrossRefGoogle Scholar
  170. Sanchez MG, Bourque M, Morissette M, Di Paolo T (2010) Steroids–dopamine interactions in the pathophysiology and treatment of CNS disorders. CNS Neurosci Ther 16(3):e43–e71. PubMedCrossRefGoogle Scholar
  171. Seedat S, Scott KM, Angermeyer MC, Berglund P, Bromet EJ, Brugha TS, Demyttenaere K, de Girolamo G, Haro JM, Jin R, Karam EG, Kovess-Masfety V, Levinson D, Medina Mora ME, Ono Y, Ormel J, Pennell BE, Posada-Villa J, Sampson NA, Williams D, Kessler RC (2009) Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. Arch Gen Psychiatry 66(7):785–795. PubMedPubMedCentralCrossRefGoogle Scholar
  172. Seeman MV (2013) Women and schizophrenia: new findings. Neuropsychiatry 3(4):423–431CrossRefGoogle Scholar
  173. Shibre T, Medhin G, Alem A, Kebede D, Teferra S, Jacobsson L, Kullgren G, Hanlon C, Fekadu A (2015) Long-term clinical course and outcome of schizophrenia in rural Ethiopia: 10-year follow-up of a population-based cohort. Schizophr Res 161(2-3):414–420. PubMedCrossRefGoogle Scholar
  174. Shimamoto A, Rappeneau V (2017) Sex-dependent mental illnesses and mitochondria. Schizophr Res 187:38-46. doi:
  175. da Silva TL, Ravindran AV (2015) Contribution of sex hormones to gender differences in schizophrenia: a review. Asian J Psychiatr 18:2–14. PubMedCrossRefGoogle Scholar
  176. Smieskova R, Marmy J, Schmidt A, Bendfeldt K, Riecher-Rössler A, Walter M, Lang UE, Borgwardt S (2013) Do subjects at clinical high risk for psychosis differ from those with a genetic high risk?—a systematic review of structural and functional brain abnormalities. Curr Med Chem 20(3):467–481PubMedPubMedCentralGoogle Scholar
  177. Spitz A, Studerus E, Koranyi S, Rapp C, Ramyead A, Ittig S, Heitz U, Uttinger M, Riecher-Rössler A (2015) Correlations between self-rating and observer-rating of psychopathology in at-risk mental state and first-episode psychosis patients: influence of disease stage and gender. Early Interv Psychiatry 11:461-470. doi:
  178. Sun J, Walker AJ, Dean B, van den Buuse M, Gogos A (2016) Progesterone: the neglected hormone in schizophrenia? A focus on progesterone–dopamine interactions. Psychoneuroendocrinology 74:126–140. PubMedCrossRefGoogle Scholar
  179. Taherianfard M, Shariaty M (2004) Evaluation of serum steroid hormones in schizophrenic patients. Indian J Med Sci 58(1):3–9PubMedGoogle Scholar
  180. Takahashi T, Kawasaki Y, Kurokawa K, Hagino H, Nohara S, Yamashita I, Nakamura K, Murata M, Matsui M, Suzuki M, Seto H, Kurachi M (2002) Lack of normal structural asymmetry of the anterior cingulate gyrus in female patients with schizophrenia: a volumetric magnetic resonance imaging study. Schizophr Res 55(1-2):69–81PubMedCrossRefGoogle Scholar
  181. Takahashi T, Nakamura K, Nishiyama S, Furuichi A, Ikeda E, Kido M, Nakamura Y, Kawasaki Y, Noguchi K, Seto H, Suzuki M (2013) Increased pituitary volume in subjects at risk for psychosis and patients with first-episode schizophrenia. Psychiatry Clin Neurosci 67(7):540–548. PubMedCrossRefGoogle Scholar
  182. Takayanagi Y, Takahashi T, Orikabe L, Mozue Y, Kawasaki Y, Nakamura K, Sato Y, Itokawa M, Yamasue H, Kasai K, Kurachi M, Okazaki Y, Suzuki M (2011) Classification of first-episode schizophrenia patients and healthy subjects by automated MRI measures of regional brain volume and cortical thickness. PLoS One 6(6):e21047. PubMedPubMedCentralCrossRefGoogle Scholar
  183. Taylor GT, Maloney S, Dearborn J, Weiss J (2009) Hormones in the mentally disturbed brain: steroids and peptides in the development and treatment of psychopathology. Cent Nerv Syst Agents Med Chem 9(4):331–360PubMedCrossRefGoogle Scholar
  184. Theodoridou A, Hengartner MP, Heekeren K, Dvorsky D, Schultze-Lutter F, Gerstenberg M, Walitza S, Rössler W (2017) Influence of demographic characteristics on attenuated positive psychotic symptoms in a young, help-seeking, at-risk population. Early Interv Psychiatry doi:
  185. Thorup A, Petersen L, Jeppesen P, Ohlenschlaeger J, Christensen T, Krarup G, Jorgensen P, Nordentoft M (2007) Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study. J Nerv Ment Dis 195(5):396–405. PubMedCrossRefGoogle Scholar
  186. Thorup A, Albert N, Bertelsen M, Petersen L, Jeppesen P, Le Quack P, Krarup G, Jorgensen P, Nordentoft M (2014) Gender differences in first-episode psychosis at 5-year follow-up—two different courses of disease? Results from the OPUS study at 5-year follow-up. Eur Psychiatry 29(1):44–51. PubMedCrossRefGoogle Scholar
  187. Toffol E, Heikinheimo O, Partonen T (2015) Hormone therapy and mood in perimenopausal and postmenopausal women: a narrative review. Menopause, 22(5), 564–578.PubMedCrossRefGoogle Scholar
  188. Trotman HD, Holtzman CW, Walker EF, Addington JM, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Heinssen RK, Mathalon DH, Tsuang MT, Perkins DO, Seidman LJ, Woods SW, McGlashan TH (2014) Stress exposure and sensitivity in the clinical high-risk syndrome: initial findings from the North American Prodrome Longitudinal Study (NAPLS). Schizophr Res 160(1-3):104–109. PubMedPubMedCentralCrossRefGoogle Scholar
  189. Tseliou F, Johnson S, Major B, Rahaman N, Joyce J, Lawrence J, Mann F, Tapfumaneyi A, Chisholm B, Chamberlain-Kent N, Hinton MF, Fisher HL, MiData C (2017) Gender differences in one-year outcomes of first-presentation psychosis patients in inner-city UK Early Intervention Services. Early Interv Psychiatry 11(3):215–223. PubMedCrossRefGoogle Scholar
  190. Vigod SN, Ross LE (2010) Epidemiology of psychotic symptoms during pregnancy and postpartum in women with schizophrenia. Curr Women’s Health Rev 6(1):17–21. CrossRefGoogle Scholar
  191. Vogeley K, Schneider-Axmann T, Pfeiffer U, Tepest R, Bayer TA, Bogerts B, Honer WG, Falkai P (2000) Disturbed gyrification of the prefrontal region in male schizophrenic patients: a morphometric postmortem study. Am J Psychiatry 157(1):34–39. PubMedCrossRefGoogle Scholar
  192. Vuksan-Cusa B, Sagud M, Rados I (2016) The role of dehydroepiandrosterone (DHEA) in schizophrenia. Psychiatr Danub 28(1):30–33PubMedGoogle Scholar
  193. Waford RN, MacDonald A, Goines K, Novacek DM, Trotman HD, Elaine FW, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Heinssen R, Mathalon DH, Tsuang MT, Perkins DO, Seidman LJ, Woods SW, McGlashan TH (2015) Demographic correlates of attenuated positive psychotic symptoms. Schizophr Res 166(1-3):31–36. PubMedPubMedCentralCrossRefGoogle Scholar
  194. Walder DJ, Mittal V, Trotman HD, McMillan AL, Walker EF (2008) Neurocognition and conversion to psychosis in adolescents at high-risk. Schizophr Res 101(1):161–168. PubMedPubMedCentralCrossRefGoogle Scholar
  195. Walder DJ, Holtzman CW, Addington J, Cadenhead K, Tsuang M, Cornblatt B, Cannon TD, McGlashan TH, Woods SW, Perkins DO, Seidman LJ, Heinssen R, Walker EF (2013) Sexual dimorphisms and prediction of conversion in the NAPLS psychosis prodrome. Schizophr Res 144(1-3):43–50. PubMedPubMedCentralCrossRefGoogle Scholar
  196. Walder DJ, Yaffe B, Ehrlich Y (2016) Chapter 5—sexual dimorphisms in psychosis risk: a neurodevelopmental perspective. In: Shansky RM (ed) Sex differences in the central nervous system. Academic Press, San Diego, pp 107–127. CrossRefGoogle Scholar
  197. Walker EF, Lewine RR (1993) Sampling biases in studies of gender and schizophrenia. Schizophr Bull 19(1):1–7 discussion 9–14PubMedCrossRefGoogle Scholar
  198. Walter A, Studerus E, Smieskova R, Tamagni C, Rapp C, Borgwardt SJ, Riecher-Rössler A (2015) Pituitary gland volume in at-risk mental state for psychosis: a longitudinal MRI analysis. CNS Spectr 20(2):122–129.
  199. Watson CS, Alyea RA, Cunningham KA, Jeng YJ (2010) Estrogens of multiple classes and their role in mental health disease mechanisms. Int J Womens Health 2:153–166PubMedPubMedCentralCrossRefGoogle Scholar
  200. Weickert TW, Allen KM, Weickert CS (2016) Potential role of oestrogen modulation in the treatment of neurocognitive deficits in schizophrenia. CNS Drugs 30(2):125–133. PubMedPubMedCentralCrossRefGoogle Scholar
  201. Wilson RP, Patel R, Bhattacharyya S (2017) Do fewer males present to clinical high-risk services for psychosis relative to first-episode services? Early Interv Psychiatry 11(5):429–435. PubMedCrossRefGoogle Scholar
  202. Wing J, Cooper JE, Sartorius N (1973) Present State Examination (PSE). Deutsche Bearbeitung von M.v.Cranach 1978. Med Res Counc (GB)Google Scholar
  203. Wing J, Cooper JE, Sartorius N (1974) Measurement and classification of psychiatric symptoms. An instruction manual for the PSE and Catego program. Cambridge University Press, LondonGoogle Scholar
  204. Zubin J, Spring B (1977) Vulnerability—a new view of schizophrenia. J Abnorm Psychol 86(2):103–126PubMedCrossRefGoogle Scholar
  205. Zucker I, Beery AK (2010) Males still dominate animal studies. Nature 465(7299):690. PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Anita Riecher-Rössler
    • 1
  • Surina Butler
    • 2
  • Jayashri Kulkarni
    • 3
  1. 1.Center of Gender Research and Early DetectionUniversity of Basel Psychiatric HospitalBaselSwitzerland
  2. 2.Faculty of Medicine, Nursing & Health SciencesMonash UniversityMelbourneAustralia
  3. 3.Monash Alfred Psychiatry Research Centre (MAPrc)MelbourneAustralia

Personalised recommendations