Gender aspects in schizophrenia: bridging the border between social and biological psychiatry


  • This paper was read in a preliminary version at the 1st International Zurich Conference on Clinical and Social Psychiatry, Zurich, 9–12 September 1999. The conference and this publication were sponsored by Eli Lilly Suisse.

Prof. Dr Anita Riecher-Rössler, University Psychiatric Outpatient Department, Petersgraben 4, CH-4031 Basel, Switzerland


Objective: This paper tries to show that gender differences in mental diseases are a valuable paradigm for research into the interplay between biological and psychosocial factors — not only regarding pathogenetic mechanisms, but also concerning therapeutic approaches.

Method: Based on relevant literature, this topic is highlighted using schizophrenia as an example.

Results: Schizophrenic disorders show a later age of onset in women and a slightly better course, especially in young women. As to pathogenesis, there is some evidence that the age difference might be due at least partly to the female sex hormone oestradiol being a protective factor. Differences in course might also have to do with this biological factor, but at the same time with the psychosocial advantages of a higher age of onset and other psychosocial factors. Concerning therapy, these gender differences have important implications for pharmacotherapy, but also psychotherapy and social measures.

Conclusion: A gender-sensitive approach in psychiatry improves our understanding of mental illness and our therapeutic strategies and at the same time illustrates that comprehensive psychiatry cannot be practised in artificially separated ‘drawers’ called ‘biological psychiatry’, on one hand, and ‘social psychiatry’ on the other.