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Transnational stability of gender differences in schizophrenia? An analysis based on the WHO study on determinants of outcome of severe mental disorders.

Gender-specific analyses of the multinational WHO-Determinants of Outcome-Study (including 1,292 cases from 10 countries) demonstrate the transnational stability of major findings on gender differences in schizophrenia: Male patients have an earlier mean age at onset in all countries. In female patients, the distribution of the age at onset shows a second peak after age 40 years. No gender differences on nuclear symptoms of schizophrenia can be detected, but on uncharacteristic symptoms, particularly some aspects of the illness behaviour, differences appear. This investigation supports the transcultural validity of gender differences found in the German ABC-Schizophrenia-Study and in the Danish-German Psychiatric Case Register studies.

Adult↗

Gender differences in opinions and practices with regard to a "healthy diet".

Socio-cultural theories about gender differences with regard to food and health constitute the point of departure for this paper, which is based on data from two representative surveys in the Norwegian population. Both were carried out in the autumn of 1994; the first with 1050, the second with 13 200 respondents above 15 years of age. The surveys included questions on: (1) opinions on food and health related issues; (2) self reported dietary changes during the last 3 years prior to the study; (3) frequency of consumption of selected foods. Gender differences are analysed and related to various socio-economic variables. Such differences, although not as pronounced as expected, were found for most of the aspects studied. The responses from women were less related to socio-economic variables than those of men, both concerning opinions on what constitutes a healthy diet, and frequency of consumption of some foods (vegetables, fruits and dairy products). Gender differences were more pronounced between than within socio-economic groups. In line with theories about women's higher health consciousness, women in general reported dietary changes corresponding to the dietary recommendations, and may also have learned more about health than men through their choice of information sources.

Adolescent↗

Gender differences in exposure to life events and adaptation to retirement.

Gender differences in the experience of life events surrounding the retirement transition and the effects of such life event experiences on men's and women's adaptation to retirement were investigated. Data based on a stratified random sample of retirees covered by Florida's State Retirement System (n = 452 women and 378 men) indicate that women report more life events than men, particularly during the period preceding retirement. Furthermore, women's retirement adaptation seems more affected than men's by the experience of life events. The major conclusion to be drawn from these results is that better understanding of gender differences in the retirement experience can be achieved only if gender variations in the circumstances of the retirement transition are acknowledged and further explored.

Adaptation, Psychological↗

Gender differences in infirmary use at a residential summer camp.

Studies of health behavior in adults show that women report more morbidity and greater health service utilization than do men, despite lower mortality rates. Explanations involve social and biological gender differences in adult life. Infirmary utilization at a residential summer camp where parental influence is minimized was studied to determine whether these gender differences occur in the pediatric age group. Three hundred ninety-eight campers, 8 to 18 years old were studied. Girls were observed to make greater use of the infirmary than boys (p less than .01) and were especially likely to present with minor trauma, both musculoskeletal (p less than .05) and skin (p less than .01). No correlation was found between age and frequency of visits. Obvious morbidity was similar for boys and girls, in that no gender difference was observed in those visiting for definite medical indications alone or in those admitted. However, a difference was evident in those visiting for minor and trivial problems, particularly in those making three or more visits for minor and trivial problems (p less than .01). Although obvious morbidity was no different in campers, girls used the infirmary more than boys in a manner similar to that reported for adult health behavior. This suggests that gender differences occur earlier than suspected and are not simply related to adult social roles.

Adolescent↗

Gender differences in food and nutrient intakes and status indices from the National Diet and Nutrition Survey of people aged 65 years and over.

OBJECTIVES: To determine the patterns and possible explanations for gender differences in food choices, nutrient intakes and status indices, especially for micronutrients, in a representative sample of older people living in Britain, who participated in the National Diet and Nutrition Survey of people aged 65 y and over during 1994-95. DESIGN: The Survey procedures included a health-and-lifestyle interview, a four-day weighed diet record, anthropometric measurements and a fasting blood sample for biochemical indices. SETTING: Eighty randomly-selected postcode sectors from mainland Britain. SUBJECTS: Of 1556 older people not living in institutions who were interviewed, 80% agreed to provide a complete four-day diet record and 63% agreed to give a blood sample for status index measurements. INTERVENTIONS: None. MAIN RESULT: The most highly significant gender differences in food choices were that women ate more butter, full-fat milk and certain beverages, cakes, apples, pears and bananas, whereas men ate more eggs, sugar, certain meat products and drank more alcoholic drinks, especially beer and lager. When adjusted for energy intakes, the younger women (65-79 y) had higher intakes than the younger men, of fat, retinol, vitamin C and calcium. The older women (80+ y) had higher intakes than older men, of fat and vitamin E, but lower intakes of protein, zinc and beta-carotene. The younger women had better status indices than the younger men: for alpha- and beta-carotenes, beta-cryptoxanthin and vitamin C. Women had higher plasma concentrations of cholesterol and HDL cholesterol, phosphate and copper, but lower indices of iron and vitamin D status, than men. These gender differences in status were not altered by inclusion of the corresponding nutrient intakes in the model. CONCLUSIONS: There are gender differences in food choices, in energy and nutrient intakes and in nutritional blood status indices in older British people, especially those aged 65-79 y. Some of the status differences are attenuated in the age group of 80 y and older, whereas others are enhanced. The relationships between the quantity and type of foods or nutrients consumed, and nutrient status, are complex. With respect to suspected risk and protective factors for vascular disease, women aged 65-79 y had significantly better status for plasma alpha- and beta-carotene, ascorbate, HDL-cholesterol and homocysteine; but, in contrast, they had lower blood haemoglobin concentrations and higher concentrations of total and non-HDL-cholesterol.

Age Factors↗

Gender differences in economic well-being among the elderly of Java.

With populations aging rapidly in many developing nations, issues of economic dependency among the elderly are of increasing importance. Using data from a 1986 survey of the elderly on Java, Indonesia, I describe gender differences in economic well-being and identify characteristics associated with economic disadvantage. At both the individual and the household level, older women have fewer resources than older men. Even within categories of support (work income and remittances), women have lower levels of well-being. Gender differences in household-level economic well-being are due primarily to differences in household structure and in levels of skills. Gender differences in individual receipts (from all sources) are more complicated, but can be understood more clearly with reference to gender differences in skills levels (literacy, language, job skills), current work status and authority, and domestic authority.

Aged↗

Gender differences on thought disturbance measures among schizophrenic patients.

OBJECTIVE: This study examined gender differences on three measures of thought disturbance among patients with schizophrenia and the relation between thought disturbance and social competency. METHOD: Fifty-three male and 34 female patients diagnosed with schizophrenia according to the DSM-III-R criteria were assessed on measures of thought disturbance: subscales of the Scale for the Assessment of Positive Symptoms (SAPS), subscales of the Brief Psychiatric Rating Scale (BPRS), and the Ego Impairment Index. Gender differences on the three measures of thought disturbance and the relation of these measures to demographic variables and other variables, such as social competency, were examined. RESULTS: Male and female schizophrenic patients demonstrated similar degrees of thought disturbance on the pertinent subscales of the SAPS and the BPRS, but the male schizophrenic patients had scores showing greater impairment on the Ego Impairment Index. Furthermore, a relationship between thought disturbance and social competency was confirmed. CONCLUSIONS: These findings support other studies in which female patients were found to have a "milder" form of schizophrenia, generally characterized by better social functioning, than their male counterparts. The literature regarding gender-related differences in thought disturbance in schizophrenia has been unclear and complicated by design issues such as obtaining adequate samples of subjects and optimizing measurement selection. The findings of this study suggest that use of a converging-measures strategy allows a better assessment of thought disturbance in severely ill schizophrenic patients and an understanding of the importance of thought disorder with respect to gender-related patterns of clinical characteristics, such as social competency.

Adult↗

Gender differences in chronic disease risk behaviors through the transition out of high school.

BACKGROUND: Major life transitions (e.g., graduation from high school) are times when many changes occur in a person's social and physical environment. Men and women likely experience aspects of these changes differently. As a result, health-related behaviors likely change at these times with possible differences in these changes by gender. METHODS: Gender differences in the performance of chronic disease risk-related behaviors (fruit, juice, and vegetable intake; physical activity; tobacco and alcohol use; and sexual practices) through the transition out of high school (HS) were assessed in a secondary analysis of a nationally representative sample from the 1992 National Health Interview Survey-Youth Risk Behavior Survey. The survey was completed by 5881 young people aged 14 to 21 years. Regression discontinuity analysis with piecewise regression was performed. RESULTS: Statistically significant gender by transition effects were obtained for exercise/physical activity (decreases at the transition point for males), snuff use (decrease for females in HS), binge drinking and number of days drinking alcohol (increases for males at the transition point), and use of alcohol or drugs before sexual intercourse (decrease for females post HS). Fruit intake decreased for males and females and daily and heavy cigarette smoking increased during the HS years. Effect sizes were small but promising, given that the data set was not designed to test this hypothesis. CONCLUSION: These data offer evidence of differences by gender in chronic disease risk behaviors through the HS transition. Longitudinal studies are needed to assess the true nature of these differences, the tracking of these risk behaviors and their personal, social, and environmental determinants, including gender-specific determinants, that may explain these changes and inform future intervention development.

Adolescent↗

Gender differences in fat oxidation and sympathetic nervous system activity at rest and during submaximal exercise in older individuals.

1. Gender differences in fat oxidation at rest and during exercise may contribute to higher body fat in women. We examined gender differences in fat oxidation at rest and during submaximal exercise and their relationship to sympathetic nervous system activity, free fatty acid availability, body composition and aerobic capacity in older volunteers. 2. We measured free fatty acid kinetics using [14C]palmitate, absolute (micromol/min) and relative (respiratory quotient) rates of fat oxidation by indirect calorimetry and sympathetic nervous system activity from noradrenaline kinetics using [3H]noradrenaline in 12 older men (70+/-4 years) and 12 older women (66+/-4 years) at rest and during 30 min of submaximal exercise (45% of peak oxygen consumption). 3. At rest, men oxidized more fat than women on both an absolute (88+/-19 versus 51+/-15 micromol/min; P<0.01) and relative (respiratory quotient: 0.80+/-0. 04 versus 0.85+/-0.04; P<0.01) basis. These differences were not related to noradrenaline appearance rate, free fatty acid concentration, body composition or aerobic capacity. During exercise, fat oxidation was higher (P<0.05 to P<0.01) in men on an absolute level, but respiratory quotient did not differ. Higher absolute fat oxidation in men during exercise was explained by their higher absolute workload. Plasma free fatty acids and free fatty acid rate of appearance did not differ between men and women during exercise despite higher (P<0.05 to P<0.01) plasma noradrenaline concentrations in men. 4. We conclude that: (i) resting fat oxidation is higher in older men compared with older women independent of differences in noradrenaline appearance rate, free fatty acid availability, body composition or aerobic capacity, and (ii) despite higher plasma noradrenaline concentrations during submaximal exercise, no gender differences in free fatty acid appearance rate or fat oxidation were found. These results suggest a sex dimorphism in post-absorptive fat metabolism in the elderly.

Aged↗

Ethnic and gender differences in bone erosion in allergic fungal sinusitis.

BACKGROUND: Erosion of the bony sinus walls in allergic fungal sinusitis (AFS) is an established phenomenon. Reports of the incidence of bone erosion in AFS vary widely, and definitions of bone erosion lack uniformity. Differences in bone erosion among ethnic and gender groups have not been examined previously in the literature. METHODS: At our institution we reviewed 47 cases of AFS for ethnic and gender differences in presentation and presence of bone erosion. RESULTS: Caucasians presented at a mean 12 years later than African-Americans (p = 0.002); however, this difference was largely carried by Caucasian females. African-Americans presented with a greater incidence of bone erosion than Caucasians (p = 0.028). In addition, there are statistically significant differences in the individual paranasal sinuses affected by bone erosion in AFS. CONCLUSIONS: We examine the potential implications of ethnic and gender differences in presentation and bone erosion in AFS.

Adolescent↗

Gender differences in explicit and implicit risk attitudes: a socially facilitated phenomenon.

The present study (a) examined the question of whether gender differences in hypothetical risk decisions might be socially facilitated by the presence of gender-homogenous groups and (b) investigated the conscious and non-conscious motivators of risk-taking through the application of both explicit and implicit measures of risk attitude. Using hypothetical choice dilemma items, no gender difference was found at an individual level; however, when placed in-groups, males expressed a stronger pro-risk position than females. While males self-reported a stronger pro-risk position than did females on two explicit measures of risk-attitude, no gender differences were found on two parallel implicit measures. However, a newly developed implicit measure of risk-attitude showed its utility in the form of convergent, predictive and incremental validity with respect to a behavioural outcome.

Attitude↗

Lack of gender differences in age at onset in familial schizophrenia.

One of the most consistent findings in the epidemiology of schizophrenia is that males are younger at the onset of schizophrenia than females. However, the vast majority of studies focussing on gender differences have not considered the potential influence of genetic factors on age at onset. We investigated the impact of familial loading on gender differences in age at onset in families with at least two siblings with RDC/DSM-III-R schizophrenia or chronic schizoaffective disorder. A total of 106 sib pairs, including 38 male-male pairs, 29 female-female pairs and 39 mixed-sex pairs of siblings as well as 260 male and 221 female isolated cases with no relative of first, second or third degree suffering from psychotic or major affective illness were investigated. We found no gender differences in age at onset in familial cases. An earlier age at onset in males compared to females was observed only in isolated cases. Our data strongly support the assumption that gender differences in age at onset of schizophrenia is not consistent across all subgroups of schizophrenics.

Adolescent↗

Gender differences in cardiovascular and hypothalamic-pituitary-adrenal axis responses to psychological stress in healthy older adult men and women.

Gender differences in the neuroendocrine and cardiovascular response to psychological stress may contribute to the gender differences in the prevalence of diseases associated with hypothalamic-pituitary-adrenal (HPA) axis reactivity such as cardiovascular disease (CVD), diabetes and hypertension. We measured plasma ACTH, cortisol, heart rate (HR), and blood pressure (BP) responses in 8 men and 8 women (55-75 years) exposed to the Matt Stress Reactivity Protocol (MSRP), a psychological challenge. The MSRP elicited significant increases in HR, systolic-, and diastolic BP, ACTH and cortisol (all p<0.01). Men had significantly greater cortisol and diastolic BP responses compared to women (p<0.05). Additionally, a positive correlation between the ACTH and cortisol responses was only found in the males (r=0.71, p<0.05). There were no group differences in HR, systolic BP, or ACTH responses. We conclude, that among older adults, men respond to psychological stress with greater increases in cortisol, compared to women. This greater activation of the HPA axis could translate into an elevated risk for CVD, diabetes and hypertension and may be related to the higher prevalence of these diseases in males. Gender differences in brain structures and/or cognitive processes may be responsible for these sexually dimorphic stress responses.

Adrenocorticotropic Hormone↗

Gender differences in temperament: a meta-analysis.

The authors used meta-analytical techniques to estimate the magnitude of gender differences in mean level and variability of 35 dimensions and 3 factors of temperament in children ages 3 months to 13 years. Effortful control showed a large difference favoring girls and the dimensions within that factor (e.g., inhibitory control: d = -.41, perceptual sensitivity: d = -0.38) showed moderate gender differences favoring girls, consistent with boys' greater incidence of externalizing disorders. Surgency showed a difference favoring boys, as did some of the dimensions within that factor (e.g., activity: d = 0.33, high-intensity pleasure: d = 0.30), consistent with boys' greater involvement in active rough-and-tumble play. Negative affectivity showed negligible gender differences.

Female↗

Myocardial infarction: gender differences in coping and social support.

AIM: The aim of this review is to summarize current knowledge about gender differences in perceptions of coping and social support among patients who have experienced myocardial infarction. RATIONALE: Women with coronary heart disease have physical, social and medical disadvantages compared with their male counterparts, which can influence their perception of recovery after cardiac events. No review has been found which focuses on gender differences in coping and social support in myocardial infarction patients. METHOD: A computerized search was conducted using the keywords 'myocardial infarction', 'coping', 'gender differences' and 'social support'. Forty-one articles, published between 1990 and October 2002, were scrutinized. FINDINGS: Two studies report that women used more coping strategies than men. Several qualitative studies found that women used a variety of coping strategies. Women minimized the impact of the disease, tended to delay in seeking treatment and did not want to bother others with their health problems. Household activities were important to them and aided their recovery. Men were more likely to involve their spouses in their recovery, and resuming work and keeping physically fit were important to them. Women tended to report that they had less social support up to 1 year after a myocardial infarction compared with men. They received less information about the disease and rehabilitation and experienced lack of belief in their heart problems from caregivers. Further, they received less assistance with household duties from informal caregivers. Men tended to report more support from their spouses than did women. CONCLUSIONS: Traditional gender-role patterns may influence the recovery of patients who have experienced myocardial infarction. Caregivers may need to be more sensitive to gender-specific needs with regard to risk profiles, social roles, and the patient's own role identity. For many women, especially older ones, household duties and family responsibilities may be an opportunity and a base for cardiac rehabilitation.

Adaptation, Psychological↗

Gender differences in tobacco use in Kenya.

This study has assessed gender differences in smoking and the use of smokeless tobacco for younger adults and their parents in samples from five ethnic groups in Kenya. These samples were from two groups of pastoralists (the Maasai and the Samburu), a group engaged in fishing and farming (the Luo), and two groups of relatively Westernized Kenyans primarily involved in commercial occupations (from the Kisii and the Gikuyu ethnic groups). In four of the five study groups, there was little or no difference in the prevalence of smokeless tobacco use in either the younger or older generation. Similarly, in four of the study groups there was little or no gender difference in the prevalence of smoking for the older generation. In contrast, for the younger generation in every study group except the Luo, men were much more likely than women to smoke cigarettes. The attitudes toward tobacco use reported by the younger generation showed similar patterns. In every study group except the Luo, the younger adults reported that smokeless tobacco use was socially acceptable for both men and women, but smoking was acceptable only for men. Many of the younger women reported that they did not smoke because it would not be socially acceptable. The interview data suggest that the social prohibition against women's smoking was one component of more general restrictions on women's behavior, and the absence of restrictions on men's smoking was related to men's greater social power. The Luo were the only study group in which respondents reported that women should have as much influence as men in decision making. Correspondingly, the Luo were the only study group in which most respondents considered it acceptable for women to smoke and women were as likely as men to smoke cigarettes.

Age Factors↗

Gender difference on the symptoms, health-seeking behaviour, social impact and sleep quality in irritable bowel syndrome: a Rome II-based survey in an apparent healthy adult Chinese population in Taiwan.

BACKGROUND: Little is known about the gender effect on irritable bowel syndrome in Asia. AIM: To assess the gender difference in Chinese subjects with irritable bowel syndrome meeting Rome II criteria. METHODS: Irritable bowel syndrome was identified from an apparently healthy adult population receiving a routine health maintenance program (n = 2018). RESULTS: Female gender is not a factor associated with irritable bowel syndrome or irritable bowel syndrome-related health care-seeking behaviour. Female irritable bowel syndrome subjects, irrespective of consulting behaviour for irritable bowel syndrome, are likely to have < 3 bowel movements/week, hard/lumpy stools and abdominal fullness/bloating (P < 0.05). Female irritable bowel syndrome subjects are prone to be absent from school/work with more days of absenteeism, irrespective of consultation status (P < 0.05). Only female irritable bowel syndrome consulters have more absenteeism for their irritable bowel syndrome-related symptoms, reporting more sleep disturbances than their male counterparts (P < 0.001). CONCLUSIONS: In an apparent healthy adult population in Taiwan, gender difference is present in Rome II defined Chinese subjects with irritable bowel syndrome as regards bowel symptoms, social impact and sleep quality. Female predominance was not found in irritable bowel syndrome subjects and irritable bowel syndrome-related health care-seeking behaviour in the current population. Both irritable bowel syndrome non-consulters and consulters have similar gender difference profiles in presenting symptoms, suggesting that bowel symptoms per se may not be the only factor leading to health care-seeking behaviour. The gender differences in sleep problems were observed solely in irritable bowel syndrome consulter.

Absenteeism↗

Social roles and gender difference in the prevalence of common mental disorders.

BACKGROUND: It is not known why the most common mental disorders, anxiety and depression, are more prevalent among women then men. The aim was to test the hypothesis that this gender difference could be explained by differences between men and women in social role occupancy, after adjusting for age and socio-economic status. METHOD: A cross-sectional survey of 8979 adults aged 16-74 years living in private households in England, Wales and Scotland was carried out. Prevalence of common mental disorders was assessed using the General Health Questionnaire. RESULTS: The gender difference in the prevalence of the common mental disorders (unlike social role occupancy) did not vary with age to a statistically significant degree (unadjusted odds ratio 1.35, 95% CI 1.23-1.48) (P < 0.0001). Although those of either gender occupying the fewest, and women occupying the most social roles (after adjusting for age) had the highest prevalence of common mental disorders, neither number of social roles, occupancy of traditional 'female' caring and domestic roles, nor socio-economic status explained the gender difference in these conditions (adjusted OR 1.26, 95% CI 1.14-1.41) (P < 0.001). CONCLUSIONS: The gender difference in the prevalence of the common mental disorders is not explained by differences between men and women in the number or type of social roles occupied.

Adolescent↗