Skip to main content Accessibility help

Structural abnormalities of the brain in schizophrenia: sex differences in the Cantabria First Episode of Schizophrenia Study

  • J. L. Vázquez-Barquero (a1), M. J. Cuesta Núñez (a1), F. Quintana Pando (a1), M. De La Varga (a1), S. Herrera Castanedo (a1) and G. Dunn (a1)...


This paper examines structural brain abnormalities, as evaluated by the CT scan, in first episodes of schizophrenia and their association with sociodemographic, diagnostic and clinical variables. The investigation included all patients with a first episode of schizophrenia who, over a 2-year period, made contact with any of the public mental health services of the Autonomous Region of Cantabria in Northern Spain. Diagnostic and clinical characteristics were evaluated through the use of the Spanish version of the Present State Examination (PSE-9) and the Scales for the Assessment of Positive and Negative Symptoms (SANS and SAPS respectively). The study demonstrated the presence of structural brain abnormalities in this sample of first episode schizophrenics. These abnormalities were mainly expressed in the presence of larger VBR for schizophrenic patients than in the controls, these findings being more marked in women than in men. We failed to reveal, however, any evidence of an association of these brain abnormalities with diagnostic or clinical characteristics.


Corresponding author

1Address for correspondence: Professor J. L. Vázquez-Barquero, Social Psychiatry Research Unit of Cantabria, University Hospital ‘Marqués de Valdecilla’, Avda, Valdecilla s/n, 39008—Santander, Spain.


Hide All
Andreasen, N. C. (1983). The Scale for the Assessment of Negative Symptoms (SANS). University of Iowa: Iowa City, Iowa.
Andreasen, N. C. (1984). The Scale for the Assessment of Positive Symptoms (SAPS). University of Iowa: Iowa City, Iowa.
Andreasen, N. C. & Olsen, S. (1982). Negative versus positive schizophrenia: definition and validation. Archives of General Psychiatry 39, 789794.
Andreasen, N. C., Smith, M. R., Jacoby, C. G., Dennert, J. W. & Olsen, S. A. (1982). Ventricular enlargement in schizophrenia: definition and prevalence. American Journal of Psychiatry 139, 292296.
Andreasen, N. C., Swayze, V. W., Flaum, M., Yates, W. R., Arndt, S. & McChesney, C. (1990). Ventricular enlargement in schizophrenia evaluated with computed tomographic scanning. Archives of General Psychiatry 47, 10081015.
Cannon, T. D. & Marco, E., (1994). Structural brain abnormalities as indicators of vulnerability to schizophrenia. Schizophrenia Bulletin 20, 89101.
Farmer, A., Jackson, R., McGuffin, P. & Storey, P. (1987). Cerebral ventricular enlargement in chronic schizophrenia: consistencies and contradictions. British Journal of Psychiatry 150, 324330.
Flaum, M., Arndt, S. & Andreasen, N. C. (1990). The role of gender in studies of ventricle enlargement in schizophrenia: a predominantly male effect. American Journal of Psychiatry 147, 13271332.
Gittelman-Klein, R. & Klein, D. F. (1969). Premorbid asocial adjustment and prognosis in schizophrenia. Journal of Psychiatric Research 7, 3553.
Goldstein, M. J. (1988). Further data concerning the relation between premorbid adjustment and paranoid symptomatology. Schizo phrenia Bulletin 4, 236243.
Iacono, W. G. & Beiser, M. (1992). Are males more likely than females to develop schizophrenia? American Journal of Psychiatry 149, 10701074.
Iacono, W. G., Smith, G. N., Moreau, M., Beiser, M., Fleming, A. E., Lin, T. & Falk, B. (1988). Ventricular and sulcal size at the onset of psychosis. American Journal of Psychiatry 145, 820824.
Jablensky, A., Sartorius, N., Ernberg, G., Anker, M., Korten, A., Cooper, J. E., Day, R. & Bertel, A. (1992). Schizophrenia: Manifestations, Incidence and Course in Different Cultures. A World Health Organization Ten-Country Study. Psychological Medicine Monograph Supplement 20. Cambridge University Press: Cambridge.
Johnstone, E. C., Frith, C. D., Crow, T. J., Ausband, J. & Kreel, L. (1976). Cerebral ventricular size and cognitive impairment in chronic schizophrenia. Lancet 2, 924926.
Kaiya, H., Uematsu, M., Ofuji, M., Nishida, A., Morikiyo, M. & Adachi, S. (1989). Computerised tomography in schizophrenia. Familial versus non-familial forms of illness. British Journal of Psychiatry 155, 444450.
Klausner, J. D., Sweeney, J. A., Deck, M. D. F., Haas, G. L. & Kelly, A. B. (1992). Clinical correlates of cerebral ventricular enlargement in schizophrenia. Further evidence for lobe disease. Journal of Nervous and Mental Disease 180, 407412.
Lewine, R. R. J., Gulley, L. R., Risch, S. C., Jewart, R. & Houpt, J. L. (1990). Sexual dimorphism, brain morphology, and schizophrenia. Schizophrenia Bulletin 16, 195203.
Marks, R. C. & Luchins, D. J. (1990). Relationship between brain imaging findings in schizophrenia and psychopathology. A review of the literature relating to positive and negative symptoms. In Schizophrenia: Positive and Negative Symptoms and Syndromes (ed. Andreasen, N. C.), pp. 89123. Kargen: New York.
Murray, R., Lewis, S. & Revely, A. (1985). Towards an aetiological classification of schizophrenia. Lancet iv, 10231026.
Nasrallah, H. A., Jacoby, C. G., McCalley-Whitters, M. & Kuperman, S. (1982). Cerebral ventricular enlargement in subtpes of chronic schizophrenia. Archives of General Psychiatry 39, 774777.
Nasrallah, H. A., Schwarzkopf, S. B., Olson, S. C. & Coffman, J. A. (1990). Gender differences in schizophrenia on MRI brain scans. Schizophrenia Bulletin 16, 205210.
Obiols, J. E., Salvador, L., Humbert, M. & Obiols, J. (1985). Evaluación de los síntomas negativos de la esquizofrenia. Revista del Departamento de Psiquiatría de la Facultad de Medicina de Barcelona 12, 8591.
Obiols, J. E., Ruscalleda, J. & Masferrer, M. (1986). Ventricular enlargement in young chronic schizophrenics. Acta Psychiatrica Scandinavica 73, 4244.
Owens, D. D. C., Johnstone, E. C., Crow, T. J., Frith, C. D., Jagoe, J. R. & Kreel, L. (1985). Lateral ventricular size in schizophrenia: relationship to the disease process and its clinical manifestations. Psychological Medicine 15, 2741.
Pandurangi, A. K., Bilder, R. M., Rieder, R. O., Muherjee, S. & Hamer, R. H. (1988). Schizophrenia symptoms and deterioration. Relation to computed tomograpic findings. Journal of Nervous and Mental Disease 176, 200206.
Prefferbaum, A., Zipursky, R. B., Lim, K. O., Zatz, L. M., Stahl, S. M. & Jennigan, T. L. (1988). Computed tomographic evidence for generalized sulcal and ventricular enlargement in schizophrenia. Archives of General Psychiatry 45, 633640.
Reveley, A. M., Reveley, M. A. & Murray, R. M. (1983). Enlargement of cerebral ventricles in schizophrenics confined to those without known genetic predisposition. Lancet ii, 525.
Ring, N., Tantam, D., Montague, L., Newby, D., Black, D. & Morris, J. (1991). Gender differences in the incidence of definite schizophrenia and atypical psychosis—focus on negative symptoms of schizophrenia. Acta Psychiatrica Scandinavica 84, 489496.
Romani, A., Merello, S., Gozzoli, L., Zerbi, F., Grassi, M. & Cosi, V. (1987). P300 and CT scan in patients with chronic schizophrenia. British Journal of Psychiatry 151, 506513.
Salvador, L., Obiols, J. E., Humbert, M. & Obiols, J. (1985). Evaluación de los síntomas positivos en la esquizofrenia. Revista del Departamento de Psiquiatría de la Facultad de Medicina de Barcelona 12, 92102.
Schulz, S. C., Koller, M. M., Kishore, P. R., Hamer, R. M., Gehl, J. J. & Friedel, R. O. (1983). Ventricular enlargement in teenage patients with schizophrenia spectrum disorder. American Journal of Psychiatry 140, 15921595.
Schwarz, R., Biehl, H., Krumm, B. & Schubart, C. (1980). Case-finding and characteristic of schizophrenic patients of recent onset in Mannheim. Acta Psychiatrica Scandinavica 62, Suppl. 282, 212219.
Scottish Schizophrenia Research Group (1989). The Scottish first episode schizophrenia study. VI. Computerised tomography brain scans in patients and controls. British Journal of Psychiatry 154, 492498.
Shelton, R. C., Karson, C. N., Doran, A. R., Pickar, D., Bigelow, L. B. & Weinberger, D. R. (1988). Cerebral structural pathology in schizophrenia: evidence for a selective prefrontal cortical defect. American Journal of Psychiatry 145, 154163.
Shepherd, M., Watt, D., Falloon, I. & Steeton, N. (1989). The Natural History of Schizophrenia: A Five-year Follow-up Study of Outcome and Prediction in a Representative Sample of Schizophrenics. Psychological Medicine, Monograph Supplement 15. Cambridge University Press: Cambridge.
Smith, G. N., Iacono, W. G., Moreau, M., Tallman, K., Beiser, M. & Flak, B. (1988). Choice of comparison group and finding of computerized tomography in schizophrenia. British Journal of Psychiatry 153, 667674.
SPSS Inc. (1993). SPSS for Windows. Release 6.0. SPSS Inc.: Chicago.
Synek, V., Reuben, J. R. & Boulay, G. H. (1976). Comparing Evans' index and computerized axial tomography in asessing relationship of ventricular size to brain size. Neurology 26, 231233.
Takahasi, R., Inaba, Y. & Inanaga, K. (1981). CT scanning and the investigation of schizophrenia. Biological Psychiatry 9, 259268.
Turner, S. W., Toone, B. K. & Brett-Jones, J. R. (1986). Computerized tomographic scan changes in early schizophrenia: preliminary findings. Psychological Medicine 16, 219225.
Van Horn, J. D. & McManus, I. C. (1992). Ventricular enlargement in schizophrenia. A meta-analysis of studies of the ventricle: brain ratio (VBR). British Journal of Psychiatry 160, 687697.
Vázquez-Barquero, J. L., Díez Manrique, J. F., Peña, C., Aldama, J., Samaniego Rodriguez, C., Arango, J. & Mirapeix, C. (1987). A community mental health survey in Cantabria: a general description of morbidity. Psychological Medicine 17, 227241.
Vázquez-Barquero, J. L., Cuesta Nuñez, M. J., de la Varga, M., Herrera Castanedo, S., Gaite, L. & Arenal, A. (1995 a). The Cantabria first episode schizophrenia study: a summary of general findings. Acta Psychiatrica Scandinavica 91, 1561620.
Vázquez-Barquero, J. L., Lastra, I., Cuesta Nuñez, M. J., Herrera Castanedo, S., Gaite, L. & Pardo, G. (1995 b). Análisis psicopatológico de las fases iniciales de la esquizofrenia: estudio de primeros episodios de esquizofrenia de Cantabria. Psiquiatría Biológica (in the press).
Vázquez-Barquero, J. L., de la Varga, M., Cuesta Núñez, M. J., Herrera Castanedo, S., Díez Manrique, J. F., Pardo, G. & Dunn, G. (1995 c). The influence of age and other sociodemographic and clinical variables on the diagnostic characteristics of first episodes of schizophrenia. Psychological Medicine (submitted).
Weinberger, D. R., Torrey, E. F., Neophytides, A. N. & Wyatt, R. J. (1979). Lateral cerebral ventricular enlargement in chronic schizophrenia. Archives of General Psychiatry 36, 735739.
Weinberger, D. R., Cannon-Spoor, E., Potkin, S. G. & Wyatt, R. J. (1980). Poor promorbid adjustment and CT scan abnormalities in chronic schizophrenia. American Journal of Psychiatry 137, 14101413.
Weinberger, D. R., DeLisi, L. E., Perman, G. P., Targum, S. & Wyatt, R. J. (1982). Computer tomography in schizophreniform disorder and other acute psychiatric disorders. Archives of General Psychiatry 39, 778783.
Wing, J., Cooper, J. E. & Sartorius, N. (1974). Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.

Structural abnormalities of the brain in schizophrenia: sex differences in the Cantabria First Episode of Schizophrenia Study

  • J. L. Vázquez-Barquero (a1), M. J. Cuesta Núñez (a1), F. Quintana Pando (a1), M. De La Varga (a1), S. Herrera Castanedo (a1) and G. Dunn (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed