Age of onset and quality of life among males and females with schizophrenia: A national study

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Background: Age of onset is considered central to understanding the course of schizophrenia, yet little is known regarding its association with quality of life in general, and specifically among males and females. Aims: To examine the association between the age of schizophrenia onset and quality of life, in general, and among males and females, using data from a national sample and competing statistical models. Methods: Participants with a diagnosis of schizophrenia (N = 1624) completed the Manchester Short Assessment of Quality of Life (MSA-QoL) and were rated on a parallel measure by their professional caregivers (N = 578). Multiple regression analysis models were computed for self-appraised quality of life, and mixed models with random intercepts were used for caregivers. Six competing models were tested for parsimony for each rating source. Three models without adjustment and three models adjusted for confounding variables. Sensitivity analyses were conducted for males and females separately. Results: Age of onset was statistically significantly (P <.05) negatively associated with self-appraised and caregiver-appraised quality of life on aggregate and among females. Among males, a significant (P <.01) quadratic effect of onset age on self-appraised quality of life demonstrated a negative association up to onset age of 36.67 years, after which the association was positive. Conclusions: An earlier age of onset is associated with a better quality of life in schizophrenia which is tentatively explained by social decline. Specific trends in psychiatric symptom severity may account for this association among females while social advantages may account for the particular results found among males.

Original languageEnglish
Pages (from-to)100-106
Number of pages7
JournalEuropean Psychiatry
StatePublished - Sep 2018

Bibliographical note

Funding Information:
This publication is based on the results of the Outcomes Project that was conducted by Professor David Roe and Professor Marc Gelkopf of The Center for Mental Health Research, Practice and Policy at the Department of Community Mental Health with joint funding from the Israeli Ministry of Health and the Laszlo N. Tauber Family Foundation .

Funding Information:
We are grateful acknowledge for the ongoing collaboration with the Mental Health Rehabilitation Department, especially Ronit Dudai and Vered Balush, and the Department of Information and Evaluation at the Ministry of Health, especially Rinat Yoffe as well as the entire team of the Psychiatric Rehabilitation Patient Reported Outcome Measurement project, notably Aid Rohanna, Paula Garber, Adi Telem and Ronit Mirkin. We acknowledge with thanks the support of The Center for Mental Health Research, Practice and Policy at the University of Haifa.

Publisher Copyright:
© 2018 Elsevier Masson SAS


  • Competing models
  • Epidemiology
  • Male female differences
  • Psychometric
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health


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