Gender and schizophrenia: association of age at onset with antecedent, clinical and outcome features

Objective: There is evidence that gender and age at onset may have a bearing on schizophrenia. The extent to which this differential age at onset influences the clinical features of schizophrenia and its outcome in males and females is not clear. Method: One hundred and twenty outpatients with DSM-III-R schizophrenia were studied to determine the association of antecedent, historical, clinical and 13-year outcome features with age at onset in females (n = 64) and in males (n = 56), Results: Males were significantly younger at illness onset but were not otherwise different from females in antecedent features of illness, For males, age at onset bore little relationship to outcome after 13 years. Females with early onset of illness were more likely to have experienced obstetric complications, to evidence poorer premorbid functioning, and to have a worse clinical, social and functional outcome than females with late onset. Conclusions: Even though females may have a more benign illness than males, among females, those with early age at onset may be characterised by neurodevelopmental deviance and worse illness outcome.