© 1998 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Causes and Consequences of the Gender Difference in Age at Onset of Schizophrenia
Head of the Schizophrenia Research Unit
Deputy Director, Schizophrenia Research Unit
Sociologist; at the Central Institute of Mental Health Mannheim, Germany
Psychologist; at the Central Institute of Mental Health Mannheim, Germany
Psychologist; at the Central Institute of Mental Health Mannheim, Germany
Senior Scientist; at the Central Institute of Mental Health Mannheim, Germany
Psychologist, at the Central Institute of Mental Health Mannheim, Germany
Head of the Institute for Basic Psychiatric Research Psychiatric Hospital Risskov, Denmark
Deputy Head, Department of Psychiatry and Psychotherapy, University of Cologne, School of Medicine Cologne, Germany
Intern, Department of Neurology, Faculty of Clinical Medicine, University of Heidelberg Mannheim, Germany
Professor and Chairman, Department of Psychiatry, Faculty of Medicine, University of São Paulo Brazil
Reprint requests should be sent to Prof. Dr. H. Häfner, Head, Schizophrenia Research Unit, Central Institute of Mental Health, P.O. Box 12 21 20, D-68072 Mannheim, Germany
The ABC (age, beginning, course) schizophrenia study was commenced in 1987 to generate and test hypotheses about pathogenic aspects of schizophrenia. One of the main branches of the study focused on how gender influences the age distribution of onset, symptomatology, illness behavior, and early course in schizophrenia. Proceeding from one of the rare, strikingly deviating, consistent findings—the gender difference in age at first admission—we launched a systematic search for explanations by generating and testing hypotheses in a series of substudies. We moved from the epidemiological to the neurobiological and finally to the clinical level. The present article is an attempt to provide a brief overview of the individual stages of the ABC study and the different levels of investigation involved in formulating and testing the estrogen hypothesis in animal experiments and in demonstrating its applicability to human schizophrenia. From these results, three hypotheses were formulated and tested on data from an ABC study sample of 232 first-episode cases of schizophrenia. The analyses described here represent the latest stages of the ABC study.
Keywords: Gender differences / age at onset / early course
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