Gender Differences In Prognosis Of Chronic Schizophrenia And Its Relationship With Serum Sex Hormones

Objective:To explore the difference of prognosis between different genders of chronic schizophrenia and its relationship with serum sex hormones.Methods:The first-episode schizophrenics hospitalized in a secondary psychiatric hospital from January 1,2009 to December 31,2009 and from January 1,2014 to December 31,2014 were selected.According to the simple random sampling method,20 male and 20 female patients in the 10-year course group,20 male and 20 female patients in the5-year course group were selected as the research objects,the hospital health worker recruitment and social volunteers between male and female all 20 cases as control group.Using The generic quality of life inventory-74(GQOLI-74),the world health organization disability rating scale Ⅱ(WHO-DAS Ⅱ),Mini-mental State Examination(MMSE)and the subscale of disease severity(SI)in the general clinical efficacy rating scale(CGI),for 5 years duration and 10 years course of male and female patients with schizophrenia and normal control group’s quality of life,social function,cognitive function,and assess the severity of disease,and test their serum sex hormone levels(T,E2)level.On this basis,the independent sample t test was used to compare and analyze the quality of life of the two.Analysis of variance,LSD and Tamhane were used to compare the differences in social function,cognitive function,disease severity and serum sex hormones between male and female patients and the control group.Using Pearson correlation analysis test all of the patients serum sex hormone levels and the WHO-DAS Ⅱ score,MMSE score,CGI-SI scores and the correlation of GQOLI-74 total score.Results:1.In 2009,there were 710 hospitalized patients with schizophrenia,among whom135 had the first onset and 68 met the inclusion criteria;In 2014,there were 858 hospitalized patients with schizophrenia,among whom 162 had the first onset and 87 met the inclusion criteria.Finally,80 subjects were selected into the study group,including 20 males and 20 females in the 10-year disease course group and 20 males and 20 females in the 5-year disease course group,and 40 healthy controls were recruited,including 20 males and 20 females in each group.2.The total score dimension of GQOLI-74 questionnaire in the course group of 10 years was statistically significant(P = 0.029);in the body function dimension,the10-year course group male was higher than female,the difference was statistically significant(P = 0.011);in the social function dimension,the 5-year course group and the10-year course group female were higher than male group,the difference was statistically significant(P = 0.000,P = 0.000).3.The WHO-DAS Ⅱ score of female patients was lower than that of male patients(P = 0.007),and that of 5-year course group was lower than that of 10-year course group(P = 0.000).4.The MMSE score of female patients was higher than that of male patients(P =0.000),and that of 5-year course group was higher than that of 10-year course group(P= 0.000).5.CGI-SI score of 10-year course group was higher than that of 5-year course group(P = 0.044),and that of male patients was higher than that of female patients(P =0.000).6.Comparison of serum sex hormone level:(1)the mean value of serum T level in different course groups was lower than that in the control group,the difference was statistically significant(P = 0.006,P = 0.013),and the dispersion of serum T level in men was large;(2)the serum E2 level in 10-year course group was lower than that in the normal control group(P =(3)the serum E2 level of the 5-year course group and the10-year course group was lower than that of the control group,the difference was statistically significant(P = 0.000,P = 0.000).7.Correlation between serum sex hormone level(E2,t)and WHO-DAS Ⅱ,CGI-SI,MMSE,GQOLI-74 total score The Pearson correlation analysis of serum T,E2 and WHO-DAS Ⅱ,CGI-SI,MMSE,GQOLI-74 total score dimension score data showed that:(1)the serum T level of male patients was negatively correlated with WHO-DAS Ⅱ score(r =-0.497),positively correlated with MMSE,GQOLI-74(r =0.836,r = 0.428),and had no statistical significance with CGI-SI score(r =-0.173);(2)the male patients were excluded four cases with high serum T level,The serum T level of male patients was negatively correlated with WHO-DAS Ⅱ and CGI-SI scores(r =-0.358,r =-0.366),and positively correlated with MMSE and GQOLI-74 scores(r =0.757,r = 0.420).(3)The serum E2 level was negatively correlated with WHO-DASⅡ and CGI-SI scores(r =-0.351,r =-0.490),and positively correlated with MMSE and GQOLI-74(r = 0.583,r = 0.354).Conclusion:With the prolongation of the disease course,the quality of life of patients with schizophrenia is worse,and the impairment of cognitive function and social function is more obvious.However,the social function,cognitive function and the severity of the condition of female patients are better than that of male patients.Serum T level of male patients and serum E2 level of female patients may be the influencing factors for the prognosis of schizophrenia,and the level of serum T of male chronic schizophrenics may have two states.