Schizophrenia: Gender Bias

Some critics of the DSM diagnostic criteria argue that some diagnostic categories are biased towards pathologising one gender rather than the other. For example, Broverman et al. (1970) found that clinicians in the US equated mentally healthy ‘adult’ behaviour with mentally healthy ‘male’ behaviour, illustrating a form of androcentrism. As a result there was a tendency for women to be perceived as less mentally healthy when they do not show ‘male’ behaviour. Also interestingly, some research has indicated that a psychiatrist’s gender might affect their ability to diagnose.

Loring and Powell (1988) randomly selected 290 male and female psychiatrists to read two case articles of patients’ behaviour and then asked them to offer their judgment on these individuals using standard diagnostic criteria. When the patients were described as ‘male’ or no information was given about their gender, 56% were given a diagnosis of schizophrenia. However, when the patients were described as ‘female’, only 20% were given a diagnosis of schizophrenia. This gender bias did not appear to be evident amongst the female psychiatrists. This suggests that diagnosis is influenced not only by the gender of the patient but also the gender of the clinician.

Gender bias also occurs due to clinicians failing to consider that males tend to suffer more negative symptoms than women and have higher levels of substance abuse, or that females have better recovery rates and lower relapse rates. These misconceptions could be affecting the validity of a diagnosis as clinicians are not considering all symptoms.

Clinicians also ignore that there are different predisposing/risk factors between males and females, which give them different vulnerability levels at different points in life. This can possibly explain the gender difference in the onset of schizophrenia.