For schizophrenia patients with tardive dyskinesia (TD), there may be sex differences in cognitive impairment, with a protective effect suggested by female gender, according to a study published in the May issue of Schizophrenia Research.

Wanni Zhang, from Capital Normal University in Beijing, and colleagues recruited 496 schizophrenia inpatients and 362 healthy controls to examine sex differences in cognitive performance in schizophrenia patients with TD. Psychopathological symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), and the severity of TD was measured using the Abnormal Involuntary Movement Scale (AIMS). The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) was used to measure cognitive function in 313 and 310 of the patients and healthy controls, respectively.

The researchers found that compared with healthy controls, patients with schizophrenia performed worse in all cognitive domains. Patients with TD had higher PANSS total, PANSS negative symptom subscale, and AIMS scores than those without TD, as well as significantly lower RBANS total, visuospatial/constructional, and attention subscale scores. In male patients with TD, the visuospatial/constructional and attention indices remained significantly lower than those seen in patients without TD, while for female patients, these results were not observed. In male patients only, there was a negative correlation seen for visuospatial/constructional and attention indices with AIMS.

“These findings may have therapeutic implications, suggesting that female hormones, such as estrogen, may be useful in the prevention for the development of TD and impairment of cognitive function,” the authors write.

More information:
Wanni Zhang et al, Sex difference in association between tardive dyskinesia and cognitive deficits in patients with chronic schizophrenia, Schizophrenia Research (2023). DOI: 10.1016/j.schres.2023.03.034

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