Goldstein 1988

Question 1

BACK GROUND QUESTION

Answer 1

• ‘Do schizophrenic women have a less severe experience than schizophrenic men’

Question 2

AIMS

Answer 2

• To see if there are gender differences with regard to the re-hospitalisation of people with schizophrenia and to the length of their hospital stays
• To consider social factors
• To look at DSM II and DSM III diagnosis to see if there were differences and to test the DSM for reliability and validity.

Question 3

PROCEDURE/SAMPLE

Answer 3

• Used DSM III to test for gender differences in schizophrenia
• 199 patients who were male and females
• all were re-diagnosed later with the newer version of DSM III 10 years.
• Patients were aged between 18 and 45

Question 4

PROCEDURE/SAMPLE - Re-diganosis to test the DSM for reliability

Answer 4

• Patients were re-diagnosed using the DSM III.
• Hospital records gave detailed histories for the re-diganosis and single blind technique was used, where the psychiatrist was blind to the hypothesis.
• Goldstein carried out re-diagnosis and she was not blind to the hypothesis, two other experts carried out the re-diagnosis of a random sample of patients (4 men and 4 women achieved 0.80 agreement)
• out of the 199 patients who had various forms of schizophrenia according to DSM II, 169 met the criteria of the DSM II

Question 5

PROCEDURE/SAMPLE 2

Answer 5

• 90 (58 men and 32 women)
• men aged 24
• High levels of education
• 87 were non-hispanic white and middle class
• Had many types of schizophrenia
• Goldstein gathered information about symptoms, functioning before diagnosis and course of illness using questionaires and interviews.

Question 6

PROCEDURE - SYMPTOMS

Answer 6

• Symptoms were rated by trained master - levels interviewers using an instrument
• Areas covered - hallucinations, paranoia, anxiety etc
• assume Goldstein used trained interviewers and structured interviewers

Question 7

PROCEDURE - PREMORBID FUNCTIONING

Answer 7

• Measured by questionaires dealing with isolation, occupational status, peer ratings and interests.

Question 8

PROCEDURE - COURSE OF ILLNESS

Answer 8

• Operationalised by the number of re-hospitalisations and lengths of stay in hospital with data being obtained over a 10 year period.
• Data was obtained from the New York State Department of Mental Health

Question 9

RESULTS

Answer 9

• It was found men had a higher mean number of re-hospitalisations and longer stays in hospitals over a 10 year period.
• Schizophrenia women had a significantly lower mean number of re-hospitalisations and shorter stay from 1973-1983

Question 10

CONCLUSIONS

Answer 10

• Females with schizophrenia experienced fewer re-hospitalisations and shorter lengths of stays than males
• Gender differences started early in the disorder
• males have a poorer outcome than females