New research suggests that sex may play a key role in shaping the onset, progression, and clinical features of schizophrenia and bipolar disorder. The findings, published in Acta Psychiatrica Scandinavica, highlight important distinctions between males and females living with these serious mental health conditions.
The analysis drew on data from 1,516 participants in the multicenter PsyCourse Study: 543 with bipolar disorder, 517 with schizophrenia, and 456 healthy controls. Researchers examined patterns in age at diagnosis and treatment, illness duration, substance use, and cognitive functioning.
Clear sex-related differences emerged. Women with schizophrenia were typically older than men when they first sought outpatient treatment, while women with bipolar disorder received care earlier. A later start to treatment was associated with a longer course of illness overall.
Substance use also varied. Men with schizophrenia had the highest rates of illicit drug use and smoking. By contrast, individuals with bipolar disorder demonstrated better day-to-day functioning and stronger neurocognitive performance compared with those diagnosed with schizophrenia. Within the bipolar group, women outperformed men in verbal memory and psychomotor speed.
Both men and women with severe mental illnesses were more likely to experience thyroid problems than healthy controls, underscoring the need for comprehensive medical monitoring.
Researchers say these findings reinforce the importance of considering sex-based differences when diagnosing and managing schizophrenia and bipolar disorder, with potential implications for tailoring treatment strategies.
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