ArticleSchizophrenia bulletin2023
Women with Schizophrenia-Spectrum Disorders After Menopause: A Vulnerable Group for Relapse.
Article in Schizophrenia bulletin, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Sex differences in schizophrenia: symptomatology, treatment efficacy and adverse effects.Frontiers in psychiatry · 2025Pooled it
- Dementia in Rare Genetic Neurodevelopmental Disorders: A Systematic Literature Review.Neurology · 2024Pooled it
- Evidence-Based Recommendations for the Pharmacological Treatment of Women with Schizophrenia Spectrum Disorders.Current psychiatry reports · 2023Pooled it
- Sex Differences Between Female and Male Individuals in Antipsychotic Efficacy and Adverse Effects in the Treatment of Schizophrenia.CNS drugs · 2024Trial
- Clinical outcomes in first-episode psychoses: does age at admission matter?European archives of psychiatry and clinical neuroscience · 2026Article
- Targeting α5-GABAA receptors to restore dopamine system function in a translationally relevant model of perimenopausal psychosis.Psychopharmacology · 2026Article
- The influence of sex on cognition in psychosis.Schizophrenia research. Cognition · 2026Article
- Olanzapine Dosing in Women with First-Episode Psychosis: An Age-Based Proxy for Menopausal Status.Schizophrenia bulletin · 2026Article
- Examining sex as a potential moderator of metacognitive training for psychosis efficacy on cognitive insight and jumping to conclusions bias: Evidence from a large-scale harmonized database.Schizophrenia research. Cognition · 2026Article
- Practical Approach to Hormone Replacement Therapy for (Peri) Menopausal Women With Schizophrenia Spectrum Disorders: A Case Series.Schizophrenia bulletin · 2026Article
- The Impact of Sex and Age on Antipsychotic Serum Concentrations.Schizophrenia bulletin · 2026Article
- Trajectories of Clozapine Concentrations in Women Across Menopausal Age.Schizophrenia bulletin · 2026Article
- Sex Differences in Schizophrenia Across the Reproductive Lifespan.Current psychiatry reports · 2026Review
- The effect of age on the clinical presentation and treatment of women with psychosis: secondary analysis of the IMPaCT Randomised Clinical Trial.BJPsych open · 2025Article
- Reproductive and Fertility Care of Women with Schizophrenia: A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia with and without prominent negative symptoms: A prospective study.World journal of psychiatry · 2025Article
- Risk Factors for Relapse of Schizophrenia in the Elderly During the Maintenance Phase: A Matched Case-Control Study.Alpha psychiatry · 2025Article
- Article
- Antipsychotic-induced prolactin elevation in premenopausal women with schizophrenia: associations with estrogen, disease severity and cognition.Archives of women's mental health · 2024Article
- An Evaluation of a Women's Clinic: The Healthcare and Learning Project of the Functional Unit for Women with Schizophrenia.Healthcare (Basel, Switzerland) · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and hypothesisThroughout the life stages of women with schizophrenia-spectrum disorders (SSD), lower estrogen levels are associated with more severe disease course. At perimenopause in the mid-forties, estrogen levels decline to remain persistently low after menopause. This period is hypothesized to increase relapse risk and reduce antipsychotic effectiveness in preventing relapse. STUDY
designThe cohort of persons with schizophrenia/schizoaffective disorder was identified from Finnish nationwide registers (N = 61 889) and stratified by sex and age <45 vs. ≥45 years. Hospitalizations for psychosis were defined per 5-year age group during the follow-up 1996-2017. Risk of psychosis hospitalization (Adjusted Hazard Ratio, aHR) was assessed using within-individual design, by comparing antipsychotic monotherapy use to nonuse periods in the same individuals for seven dose categories in defined daily doses (DDDs/day).
resultsStarting at age 45-50, women were consistently more often hospitalized for psychosis than their male peers. Women ≥45 had significantly higher aHRs than women <45 at antipsychotic monotherapy >0.6 DDDs/day, and than men at >1.1 DDDs/day. This female-specific age-dependent decrease in effectiveness was present for clozapine doses >0.6 DDDs/day, olanzapine doses >1.4 DDDs/day, and for specific doses of quetiapine (0.9-1.1 DDDs/day) and risperidone (0.6-0.9 DDDs/day).
conclusionsWhile younger women have a lower risk of relapse and generally need a lower antipsychotic dose to prevent rehospitalization than men, antipsychotic effectiveness declines in women after the age of 45. Starting in mid-forties, older women with SSD should be regarded as a vulnerable group that deserve special attention.
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