There is no disparity in the occurrence and prevalence of schizophrenia between men and women, though schizophrenia is more closely associated with younger men. This may be due to the fact that women are more likely to experience the onset of schizophrenia later than men. Women tend to develop symptoms in their late 20s whereas the onset in men is typically in their early 20s.1 Also, because women with schizophrenia tend to be more socially active, their schizophrenia may be less detectable.

Symptoms of Women with Schizophrenia

The criteria for a diagnosis of schizophrenia is the same for women as it is for men, but the features of schizophrenia differ between the genders. For example, women may exhibit depression or anxiety which may put them at a higher risk for suicide.2

Women with schizophrenia are less likely to have symptoms such as:

  • Flat affect (monotonous voice, dull expression)
  • Blunted emotional responses (not reacting strongly emotionally to good or bad news)
  • Speech reduction
  • Social withdrawal

Women with schizophrenia may be more physically active and more hostile than men with the illness. They may also experience more auditory hallucinations as well as paranoid and persecutory delusions. Paranoid delusions consist of thoughts like, “my spouse is cheating on me,” when he isn’t. Persecutory delusions consist of thoughts like, “I’m being mistreated,” when there is no actual mistreatment. Not every woman with schizophrenia will exhibit these features, but these trends have been noted in some large-scale studies.3

Life Challenges for Women with Schizophrenia

Typically, women with schizophrenia function better socially than men, often because a later age of onset indicates a less severe form of mental illness. Women with schizophrenia are likely to experience fewer hospitalizations and shorter visits while in the hospital compared to men. Some researchers believe that this later onset is because hormones like estrogen have a protective effect.4 However, this disparity in the age of onset is not present in all ethnic groups. For example, multiple studies in the country of India have found no difference in the mean age of onset between men and women.5

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Women with schizophrenia are more likely to be married and have children. They’re also more likely to have unplanned pregnancies than women without the condition. In developed countries, women with schizophrenia experience higher rates of homelessness. They are, however, less likely than men to have a substance use disorder or smoking problem. Older women experience severe tardive dyskinesia (TD), an involuntary movement disorder usually seen in the jaw, lips and tongue caused by antipsychotic medications, more often than older men.6 Finally, being female and having schizophrenia is also more closely associated with a higher incidence of migraines and thyroid problems.

Treating Women with Schizophrenia

Though treatment for mental illness is not typically separated by gender, clinicians serve women best by considering their unique experience of schizophrenia as well as the unique challenges they face. Because women have later onset of the illness and are less likely to experience affective symptoms, clinicians must be careful to rule out other mental illnesses, such as schizoaffective disorder or bipolar disorder, when giving a diagnosis of schizophrenia.

Treatment for women with schizophrenia should include psychoeducation and support for the needs of mothers with children. Antipsychotic medication can affect the ability to breast feed and the amount of energy a mother has to parent her children.7 Treatment plans tailored for women should include education about physical health as well. Women with schizophrenia are less likely to care for their physical health. This leaves them at risk for untreated breast cancer, osteoporosis, and thyroid conditions. Mental health professionals should also consider creating safety plans for women with schizophrenia who are at increased risk for committing suicide.

Every person with mental illness is an individual and they experience the challenges of their mental illness as individuals. Women with schizophrenia are no exception. However, mental health professionals and family members serve them best when they educate themselves about the common symptoms and challenges women with this mental illness face. It is vital to remember that schizophrenia is not just a young man’s disorder.

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Last Updated: Feb 13, 2018