Gender-specific perspectives in schizophrenia: Recent advances and future directions

Schizophrenia is a severe psychiatric disorder that occurs more frequently in males than in females. Males typically show symptoms earlier in life, while females tend to develop symptoms later, with a peak after menopause. Men have a higher incidence rate, but the overall prevalence is similar between genders. Several studies have identified potential biopsychosocial reasons for these differences. The “estrogen hypothesis,” which suggests a neuroprotective effect of estrogen in women, has gained support despite limited evidence for genetic and neurodevelopmental factors. Differences based on symptoms have also been connected to distinct psychological vulnerabilities in men and women. Emerging research indicates that genetic and neurodevelopmental factors may play a less significant role in female schizophrenia compared to males. In this context, the estrogen hypothesis, which proposes a neuroprotective role for estrogen, has gained attention as a possible explanation for sex-related differences in disease expression and progression. These gender-based differences in schizophrenia might reflect variations in symptom profiles that are influenced by underlying psychological and neurobiological vulnerabilities unique to each sex. A thorough investigation of these gender-specific mechanisms is necessary to deepen understanding of the causes and to develop more personalized and effective treatments.