Gender and age at onset in schizophrenia: impact of family history

OBJECTIVE: The 1-year prevalence of schizophrenia was studied in a limited geographical area of Reunion Island (Indian Ocean) to assess the impact of family history of schizophrenia on the well-known association between gender and age at onset. METHOD: The population of schizophrenic patients meeting the DSM-III-R criteria for schizophrenia (N = 663) was identified and divided according to the presence of another schizophrenic patient among the first- and second-degree relatives. RESULTS: As previously reported, the median age at onset differed between the sexes: the males had an earlier onset (mean age = 27.8 years) than the females (31.5 years). Comparison of the ages at onset according to family history revealed that onset was later for female subjects with a negative family history than for the three other groups (i.e., males with or without a family history and females with a family history). No difference emerged in the comparison of the ages at onset of the males and females with a positive family history. CONCLUSIONS: Comparison of schizophrenic patients with familial versus sporadic disorder confirms the absence of a gender effect for age at onset in the subgroup with familial disorder. This approach also demonstrates the existence of a subgroup composed of affected females having late onset and no family history of schizophrenia.