Sex differences in illness presentation, course, and level of functioning in substance-abusing schizophrenia patients

Studies of gender differences in schizophrenia have concluded that women experience a more benign form of the illness than men as evidenced by later age of illness onset, less debilitating psychiatric symptomatology, fewer psychiatric hospitalizations, and better premorbid and overall functioning. Little research, however, has focused on documenting the potential negative impact of substance use on these clinical outcomes. The purpose of this study was to evaluate gender differences in the effects of substance use on the course and presentation of schizophrenia. Two groups of schizophrenia outpatients were evaluated: 34 with substance-use disorders and 33 with no history of substance-use disorders. Sex comparisons were conducted on rates of current psychiatric symptoms: age of onset, number of previous hospitalizations and ratings of general level of functioning. The results suggest that the more benign course and presentation of illness ordinarily seen in women with schizophrenia become muted when they use substances. The data further suggest that women may be especially vulnerable to the adverse effects of substance use. Collectively, these findings highlight the need for additional research and the development of more effective treatment interventions for this population of women. (C) 2000 Elsevier Science B.V. All rights reserved.