Potential Explanatory Models of the Female Preponderance in Very Late Onset Schizophrenia
Bibliographic record
Abstract
Epidemiological and clinical studies have uniformly reported an overrepresentation of females with very-late-onset schizophrenia-like psychotic disorder (VLOS), in stark contrast to the sex distribution of early-onset schizophrenia. Various explanatory models have been proposed to account for these sex differences, including (a) antidopaminergic effects of estrogen, (b) differential vulnerability to subtypes, (c) neurodegenerative differences between the sexes, and (d) and sex differences in age-related psychosocial and neurological risk factors; however, these models have not yet been critically evaluated for their validity. Keywords related to VLOS symptomatology, epidemiology, and sex/gender were entered into the PubMed, MEDLINE, and Google Scholar databases spanning all years. Through a narrative review of symptomatology and pathophysiology of VLOS, we examine the strengths and limitations of the proposed models. We present a comprehensive biopsychosocial perspective to integrate the above models with a focus on the role of neuroinflammation. There is significant room for further research into the mechanisms of VLOS that may help to explain the female preponderance; the effects of estrogen and menopause, neuroinflammation, and dopaminergic transmission; and their interaction with age-related and lifetime psychosocial stressors and underlying biological vulnerabilities.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".