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. 2023 Apr;273(3):601-611.
doi: 10.1007/s00406-022-01473-x. Epub 2022 Aug 16.

Sex differences in prevalence and clinical correlates of insomnia in Chinese patients with chronic schizophrenia

Rongrong Zhu  1   2 , Dongmei Wang  1   2 , Huixia Zhou  1   2 , Wenjia Wang  1   2 , Shuochi Wei  1   2 , Dachun Chen  3 , Meihong Xiu  3 , Li Wang  1   2 , Xiang-Yang Zhang  4   5
Affiliations

Sex differences in prevalence and clinical correlates of insomnia in Chinese patients with chronic schizophrenia

Rongrong Zhu et al. Eur Arch Psychiatry Clin Neurosci. 2023 Apr.

Abstract

Objective: It is generally recognized that there are sex differences in many aspects of schizophrenia. The main purpose of this study was to investigate the sex differences in the prevalence and clinical correlates of insomnia in patients with chronic schizophrenia.

Methods: A total of 957 patients who met the DSM-IV diagnostic criteria for schizophrenia were recruited in this cross-sectional study (male/female = 630/327). Demographic, clinical, and insomnia data were collected using self-reported questionnaires. Fasting blood samples were collected to evaluate the status of blood lipids. Psychopathological symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS).

Results: The prevalence rate of insomnia in female patients with schizophrenia was significantly higher than that in male patients (17.3% for males and 26.3% for females; χ2 = 10.74, p = 0.001). Regression analysis showed that in male patients, insomnia was independently associated with severe PANSS positive symptoms, severe PANSS depressive factor, and high levels of low-density lipoprotein levels, while in female patients, insomnia was associated with low education level, high PANSS depressive factor, and high levels of apolipoprotein B levels.

Conclusion: This study illustrates that insomnia is more frequent in female than male schizophrenia patients, and that there are differences in the clinical correlates of insomnia by sex, suggesting that sex differences should be considered in prevention and treatment strategies for coexisting insomnia in schizophrenia patients.

Keywords: Clinical symptom; Insomnia; Schizophrenia; Sex differences.

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