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Ramsey JM, Schwarz E, Guest PC, van Beveren NJ, Leweke FM, Rothermundt M, Bogerts B, Steiner J, Bahn S. Distinct molecular phenotypes in male and female schizophrenia patients. PLoS One. 2013 ; 8(11):e78729. Pubmed Abstract

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Primary Papers: Distinct molecular phenotypes in male and female schizophrenia patients.

Comment by:  Jayashri Kulkarni
Submitted 2 December 2013
Posted 2 December 2013

Ramsey and colleagues have recently published an excellent paper in PLOS ONE in which they detail their findings in a large sample of first-episode, drug-na´ve patients. Essentially, they describe significant sex differences in 16 molecules that underpin various hormone, inflammation, and growth factor pathways that are significant in determining the cause and outcomes for schizophrenia. Severity of illness was measured in men and women and correlated with hormones, and revealed different associations.

For example, in women the inflammatory markers were negatively correlated with severity of illness, while men had a negative correlation among prolactin, testosterone, and severity of illness. This has a number of potential implications for the treatment and outcomes of schizophrenia. Of interest is that there was no clear specificity for schizophrenia and that in a smaller sample of patients with bipolar disorder and major depressive disorder, sex differences were seen in transferrin and growth hormone responses.

Overall, this paper is a very well-performed study and highlights the need to consider the gender of the patient with schizophrenia as an important predictor of etiology and treatment responses. Combined with the epidemiological data and clinical information, the gender differences point to perhaps "male" schizophrenia being a different entity from "female" schizophrenia. Certainly, the clinical implications are profound, and further studies need to also examine the sex differences.

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