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Sex Differences in Schizophrenia

For almost 30 years, Dr. Goldstein and her team have investigated hypotheses regarding the role of one's sex in understanding schizophrenia.



Dr. Goldstein and her team have been looking to explain why men are at higher risk for a more chronic form of the illness than women. Past work characterized sex differences in symptomatology, premorbid history and age at onset, course and treatment responses, genetic transmission and incidence. Her team has also cognitively characterized differences between men and women with schizophrenia and, using structural MRI, identified key brain regions in which men and women differed. Her work suggested that disruption of the hormonal regulation of the normal sexual differentiation of the brain during fetal development contributes to understanding sex differences in schizophrenia in adulthood.

The Research

This work is focused on specific maternal-to-fetal immune pathways that disrupt the normal sexual differentiation of the brain resulting in a differential vulnerability in males and females for risk for schizophrenia, sex-specific brain abnormalities in the stress response circuitry and memory circuitry, and comorbid neuroendocrine and ANS dysfunction. Ongoing studies follow a prenatal cohort 55-60 years later into adulthood, including structural and functional magnetic resonance brain imaging studies (i.e., sMRI, fMRI, and diffusion tensor imaging - DTI) in tandem with blood collection for hormonal evaluations, immune profiling and genetic/genomic analyses. Sex differences in schizophrenia are compared with those in bipolar psychosis.

Other work is investigating sex differences in the emergence of psychosis post-puberty and the vulnerability to illness progression in schizophrenia, focusing on the role of gonadal and adrenal hormonal disruption and memory dysfunction. The team's previous work demonstrated significant sex differences in memory dysfunction and abnormalities in memory circuitry in schizophrenia, with males performing worse than females.