CLINICAL HANDBOOK OF SCHIZOPHRENIA

580 VIII. SPECIAL TOPICS• Because antipsychotic drugs are stored in adipose tissue, sudden gain or loss of weight affectsefficacy and side effects of these drugs. This is a special issue for women.• Women are especially vulnerable to weight gain and to disturbances of glucose and lipidmetabolism secondary to long-term use of antipsychotics.• No drugs are fully safe for the fetus in the first trimester, but the mother’s safety and wellbeingmust take priority.• Parenting is difficult for women with schizophrenia. Extra supports are needed for preventionof mental health problems in children.• Exacerbation of psychotic symptoms after menopause is not unusual in women.REFERENCES AND RECOMMENDED READINGSAleman, A., Kahn, R. S., & Selten, J. P. (2003). Sex differences in the risk of schizophrenia: Evidencefrom meta-analysis. Archives of General Psychiatry, 60, 565–571.Angermeyer, M. C., Kuhn, L., & Goldstein, J. M. (1990). Gender and the course of schizophrenia:Differences in treated outcomes. Schizophrenia Bulletin, 16, 293–307.Cho, J. J., Iannucci, F. A., Fraile, M., Franco, J., Alesius, T. N., & Stefano, G. B. (2003). The role of theestrogen in neuroprotection: Implications for neurodegenerative diseases. NeuroendocrinologyLetters, 24, 141–147.Goldstein, J. M., Seidmann, L. J., O’Brien, L. M., Horton, N. J., Kennedy, D. N., Makris, H., et al.(2002). Impact of normal sexual dimorphisms on sex differences in structural brain abnormalitiesin schizophrenia assessed by magnetic resonance imaging. Archives of General Psychiatry,15, 154–164.Häfner, H. (2005). Gender differences in schizophrenia. In N. Bergemann & A. Riecher-Rössler(Eds.), Estrogen effects in psychiatric disorders (pp. 53–94). Wien New York: Springer.Könnecke, R., Häfner, H., Maurer, K., Löffler, W., & an der Heiden, W. (2000). Main risk factors forschizophrenia: Increased familial loading and pre- and peri-natal complications antagonize theprotective effect of oestrogen in women. Schizophrenia Research, 44, 81–93.Kulkarni, J., de Castella, A., Downey, M., White, S., Taffe, J., Fitzgerald, P., et al. (2002). In H. Häfner(Ed.), Risk and protective factors in schizophrenia: Towards a conceptual model of the diseaseprocess (pp. 271–284). Darmstadt, Germany: Steinkopff-Verlag.Myin-Germeys, I., Krabbendam, L., Delespaul, P. A., & van Os, J. (2004). Sex differences in emotionalreactivity to daily life stress in psychosis. Journal of Clinical Psychiatry, 65, 805–809.Riecher-Rössler, A. (2003). Oestrogens and schizophrenia. Current Opinion in Psychiatry, 16, 187–192.Sand, P., Stortebecker, P., Langguth, B., Hajak, G., & Eichhammer, P. (2004). [No evidence for genderspecificsharing of COMT alleles in schizophrenia.] Psychiatrische Praxis, 31(Suppl. 1), S58–S560.Seeman, M. V. (1982). Gender differences in schizophrenia. Canadia Journal of Psychiatry, 27, 107–112.Seeman, M. V., & Lang, M. (1990). The role of estrogens in schizophrenia gender differences. SchizophreniaBulletin, 16, 185–194.Seeman, M. V. (2004). Schizophrenia and motherhood. In M. Göpfert, J. Webster, & M. V. Seeman(Eds.), Parental psychiatric disorder (2nd ed., pp. 161–171). Cambridge, UK: Cambridge UniversityPress.