Neuropsychiatric Disease and Treatment (May 2024)

Sex Differences in Personality Disorder and Childhood Maltreatment of Patients with Schizophrenia

  • Wang X,
  • Ni X,
  • Wei Y,
  • Xu L,
  • Tang X,
  • Liu H,
  • Wang Z,
  • Chen T,
  • Wang J,
  • Zhang Q,
  • Zhang T

Journal volume & issue
Vol. Volume 20
pp. 989 – 999

Abstract

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XiaoLiang Wang,1,* XiaoDong Ni,1,* YanYan Wei,1 LiHua Xu,1 XiaoChen Tang,1 HaiChun Liu,2 ZiXuan Wang,3 Tao Chen,4,5 JiJun Wang,1 Qing Zhang,1 TianHong Zhang1 1Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, People’s Republic of China; 2Department of Automation, Shanghai Jiao Tong University, Shanghai, People’s Republic of China; 3Department of Psychology, Shanghai Xinlianxin Psychological Counseling Center, Shanghai, People’s Republic of China; 4Big Data Research Lab, University of Waterloo, Waterloo, Ontario, Canada; 5Labor and Worklife Program, Harvard University, Cambridge, MA, USA*These authors contributed equally to this workCorrespondence: TianHong Zhang; Qing Zhang, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wanping Nan Road, Shanghai, 200030, People’s Republic of China, Tel +86-21-34773065, Fax +86-21-64387986, Email [email protected]; [email protected]: Despite numerous studies investigating personality disorder (PD) and childhood maltreatment (CM) characteristics in individuals with schizophrenia (SZ), there remains a scarcity of research focusing on sex differences in PD and CM within large samples of SZ patients.Methods: A total of 592 participants (257 males, 335 females) were consecutively sampled from patients diagnosed with SZ at the psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. PDs were assessed using a self-reported personality diagnostic questionnaire and a structured clinical interview, while CMs were evaluated using the Chinese version of the Child Trauma Questionnaire Short Form.Results: Male patients exhibited a prominent self-reported trait of antisocial PD (t=1.972, p=0.049), while female patients demonstrated a notable emphasis on histrionic PD traits (t=− 2.057, p=0.040). Structured interviews for PD diagnoses further indicated a higher comorbidity of schizotypal (χ2=4.805, p=0.028) and schizoid (χ2=6.957, p=0.008) PDs among male patients compared to female patients. Additionally, male patients reported a higher degree (t=2.957, p=0.003) and proportion (χ2=5.277, p=0.022) of experiences of physical abuse in their self-reported CM. Logistic regression analyses highlight distinct factors: higher antisocial PD traits and physical abuse are associated with male patients, while histrionic PD traits and emotional abuse are associated with female patients.Discussion: These findings underscore the importance of recognizing and addressing sex-specific manifestations of personality pathology and the nuanced impact of CM in the clinical management of individuals with SZ. The study advocates for tailored interventions that consider the distinct needs associated with sex differences in both personality traits and CM experiences among SZ patients.Keywords: personality disorder, psychosis, abuse, neglect, schizophrenia

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