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Book Reviews   |    
Women and Schizophrenia
Reviewed by Zerrin Emel Kayatekin, M.D.
Psychiatric Services 2001; doi: 10.1176/appi.ps.52.10.1401
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edited by David J. Castle, John McGrath, and Jayashri Kulkarni; Cambridge, England, Cambridge University Press, 2000, 150 pages, $24.95 softcover

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This book is a synopsis of research on gender differences in schizophrenia. Women and Schizophrenia is written by an international multidisciplinary group of clinicians and mental health researchers. In reviewing the literature on gender differences in schizophrenia, the authors elaborate on the clinical, social, and research implications of these differences. They also reflect on the appropriate modifications to apply in the treatment of women with schizophrenia.

The first chapter provides an overview of the topic and the book. Chapter 2 addresses gender differences in the development, organization, and degeneration of the human brain in the presence of schizophrenia. The author examines the biopsychosocial determinants of male and female behavior in a developmental context.

The authors of the next two chapters focus on gender differences in age at onset of schizophrenia, premorbid functioning, clinical presentation, and course of illness. They emphasize the implications these factors have in the diagnosis and treatment of schizophrenia in women.

In chapter five the links between hormones, especially gonadal hormones, and psychosis are reviewed. The authors outline the association between psychosis and the phases of the menstrual cycle and the postpartum period. They review the literature on the effects of gonadal steroids on neurotransmitters and neuroreceptors and recommend modifications in the treatment of women with schizophrenia. They discuss the adjunctive use of hormones, especially during peri- and postmenopausal periods.

The authors of chapters 6 and 7 discuss biopsychosocial issues unique to women and how these issues affect treatment planning. They underscore the specific needs of women with schizophrenia during the reproductive years, especially in family planning and in antenatal and postnatal care. After outlining the special challenges of mothers with schizophrenia, the authors note the importance of interdepartmental liaison and recommend the provision of services to the family unit.

Chapter 8 covers several clinically relevant issues in the treatment of women with schizophrenia. The authors evaluate gender differences in pharmacokinetics and in the side effects of medications. They summarize how treatment can be modified during pregnancy, the postpartum period, and menopause. The final chapter offers a summary of the current literature on gender differences in schizophrenia and their impact on the treatment of the disorder.

The book is well organized. The chapters are related to each other yet can also be read independently. Each chapter includes a good reference list. The book is clearly written and provides a comprehensive yet concise review of the subject. It is an excellent introductory text, and I recommend it to anyone who is interested in the care of women with schizophrenia.

Dr. Kayatekin is assistant professor in the department of psychiatry and director of the Women's Program Center for Psychopharmacological Research Treatment at UMass Memorial Health Care/University Campus in Worcester, Massachusetts.

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