Gender differences in quality of life and the course of schizophrenia: National study

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Background Evidence from various sources suggests that females with schizophrenia tend to report lower quality of life than males with schizophrenia despite having a less severe course of the disorder. However, studies have not examined this directly. Aims To examine gender differences in the association between quality of life and the risk of subsequent psychiatric hospital admissions in a national sample with schizophrenia. Method The sample consisted of 989 (60.90%) males and 635 (39.10%) females with an ICD-10 diagnosis of schizophrenia. Quality of life was assessed and scored using the Manchester Short Assessment of Quality of Life. The course of schizophrenia was assessed from the number of psychiatric hospital admissions. Participants completed the quality of life assessment and were then followed up for 18-months for subsequent psychiatric admissions. Hazard ratios (HR) from Cox proportional hazards regression models were estimated unadjusted and adjusted for covariates (age at schizophrenia onset and birth year). Analyses were computed for males and females separately, as well as for the entire cohort. Results A subsample of 93 males and 55 females was admitted to a psychiatric hospital during follow-up. Higher quality of life scores were significantly (P < 0.05) associated with a reduced risk of subsequent admissions among males (unadjusted: HR = 0.96, 95% CI 0.93-0.99; adjusted HR = 0.96, 95% CI 0.93-0.99) but not among females (unadjusted: HR = 0.97, 95% CI 0.93-1.02; adjusted HR = 0.97, 95% CI 0.93-1.02). Conclusions Quality of life in schizophrenia is a gender-specific construct and should be considered as such in clinical practice and future research.

Original languageEnglish
Article numbere35
Pages (from-to)e35
JournalBJPsych Open
Issue number2
StatePublished - 1 Feb 2022

Bibliographical note

Funding Information:
This paper is based on the results of the Outcomes Project, which was conducted by D.R. and M.G. 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 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:
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.


  • Epidemiology
  • Manchester Short Assessment of Quality of Life
  • females
  • males
  • national registry data

ASJC Scopus subject areas

  • Psychiatry and Mental health


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