Prevalence represents the overall proportion of individuals in a population who have PTSD. It is different from incidence, which represents only the new cases that have developed over a particular time-period. Point prevalence is the proportion of individuals in a population who have the disorder at a given point in time (e.g., at one-month post-trauma), while period prevalence is the proportion of individuals in a population who have the disorder over specific time periods (e.g., one to two months post-trauma). Lifetime prevalence is the proportion of individuals in a population who have ever had the disorder and lifetime morbid risk also includes those who had the disorder but were deceased at the time of the survey. This topic presents the evidence for the prevalence of PTSD in males vs. females. Please also see the topics on sex differences in incidence rates and sex differences on risk for PTSD.

What is the evidence for prevalence rates in males compared to females?

Moderate to high quality evidence found lifetime prevalence rates of PTSD are nearly twice as high for women than for men (measured at 65 years of age). The prevalence of PTSD in adolescents in detention centres was higher in females than in males (18.2% vs. 8.6%). The prevalence of PTSD following road traffic accidents was higher in females than in males (28% vs. 20%). The prevalence of PTSD following road traffic accidents was also higher in female than male children and adolescents (34% vs. 22%).

April 2022

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The incidence of PTSD refers to how many new cases there are per population in a specified time-period after exposure to a specific event. It is different from prevalence, which represents how many overall cases exist. This topic presents the evidence on incidence rates in males compared to females. Please also see the topics on prevalence rates in males vs. females and the sex differences in risk of PTSD.

What is the evidence for differences in incidence rates between males and females?

Moderate quality evidence found the incidence of PTSD in children and adolescents was higher in females than males (21% vs. 11%) after exposure to any trauma. Rates were highest in female children and adolescents exposed to interpersonal trauma (33%). The incidence of PTSD following exposure to earthquakes was also higher in females than males (35% vs. 23%).

Moderate to low quality evidence found the prevalence of PTSD in mothers ranged from 23% to 49.1% within 3 months post-loss of an infant, from 0.6% to 37% between 3 months and 12 months post-loss, and from 3.3% to 15.2% by 18 years post-loss. In fathers, prevalence of PTSD ranged from 5% to 8.4% between 7 weeks and 18 years post-loss.

April 2022

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Personal characteristics, including gender, can influence one’s degree of risk for developing PTSD. How such personal characteristics may affect the development of PTSD would be influenced by other personal characteristics as well as differences in the trauma experience itself.

What is the evidence for effects of sex on risk for PTSD?

Overall, the risk of PTSD following exposure to any trauma was higher for females than for males. This has been observed in both adults and children. The quality of this evidence is generally moderate to high.

For children and adolescents, there were small associations between increased PTSD symptoms in females following any trauma exposure (females 21% vs. males 11%). Risk of PTSD was highest in females exposed to interpersonal trauma (33%). There were more PTSD symptoms in girls following the death of a parent, sibling, or close friend. The prevalence of PTSD in adolescent detention centres was higher in females than males (18.2% vs. 8.6%).

Small effects showed both adult and child females had an increased risk of PTSD following earthquakes, with the overall incidence of PTSD in females following earthquakes at 35% and 23% for males. The prevalence of PTSD following road traffic accidents was also higher in females than males (adult females: 28% vs. 20% for males, child and adolescent females: 34% vs. 22% for males).

There was a small increase in PTSD symptoms in females than males following a burn injury, and a medium-sized increase in rates of PTSD in females after a coronavirus infection (severe acute respiratory syndrome [SARS], Middle East respiratory syndrome [MERS], or coronavirus disease 2019 [COVID-19]). In the general population, a trend effect was found of greater risk of PTSD in females during the COVID-19 pandemic.

A small association was found between increased PTSD symptoms in mothers compared to fathers of chronically ill children. After the loss of a child, the prevalence of PTSD in mothers ranged from 23% to 49.1% within 3 months post-loss, from 0.6% to 37% between 3 months and 12 months post-loss, and from 3.3% to 15.2% by 18 years post-loss. In fathers, prevalence of PTSD ranged from 5% to 8.4% between 7 weeks and 18 years post-loss.

A small increase in the risk of PTSD was found in female than male military personnel and veterans.

Lifetime rates of PTSD were nearly twice as high in women than men over 65 years, although there were no differences in rates of PTSD between males and females aged over 65 years after a fall. There were also no differences in rates of PTSD between males and females following a traumatic brain injury or following exposure to secondary workplace trauma (looking after trauma victims).

August 2021

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Sex differences have been reported in schizophrenia, including differences between sexes in the age of illness onset, in functioning, in symptom profile, and in the course of illness. This summary table assesses differences in the rates of schizophrenia between males and females as differences in incidence (number of new cases in the population at risk over a specified period of time) and prevalence (proportion of individuals who have the disorder in the population at risk at a specified time point or over a specified time period). Any sex differences in rates of schizophrenia could be due to genetic and/or environmental influences.

What is the evidence for sex differences?

Moderate to high quality evidence shows a small increase in the incidence, but not the prevalence of schizophrenia in males. This effect was found only up until around 40 years of age, with no sex differences between 40 and 50 years of age, then there was higher incidence in females after 50 years of age, possibly due to loss of oestrogen. These results remained after adjusting for year of study, sample size, sampling frame (admission or contact), case ascertainment (clinical, systematic or interview), and diagnostic classification system.

Moderate quality evidence finds male sex was also more common in people assessed as being at ultra high-risk for psychosis; having attenuated psychotic symptoms or brief and limited intermittent psychotic symptoms, as well as genetic risk and functional deterioration.

April 2022

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Prevalence measures the proportion of individuals who have a disorder at a particular point in time (point prevalence) or during a specified period (annual prevalence, lifetime prevalence) and this may vary across regions. It is distinct from incidence, which refers to how many new cases there are per population in a specified time period. Lifetime prevalence is the number of individuals in a population that at some point in their life have experienced schizophrenia compared to the total number of individuals.

What is the evidence regarding sex differences in prevalence rates of schizophrenia?

Moderate quality evidence found no differences in the overall prevalence of schizophrenia between males and females. There were also similar prevalence rates of any psychotic disorder in male and female adolescents in juvenile detention (2.7% vs. 2.9%). There were similar prevalence rates of schizophrenia in homeless males and females in St Louis and Madrid. However, there were higher prevalence rates of schizophrenia in homeless women than in homeless men in Melbourne, Munich, Baltimore, and Philadelphia.

Please also see the topic on differences in incidence rates of schizophrenia between males and females.

April 2022

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Incidence refers to how many new cases of schizophrenia there are per population in a specified time period. It is different from prevalence, which refers to how many existing cases there are at a particular point in time, or over a lifetime. Incidence is usually reported as the number of new cases per 100,000 people per year, but this can vary. Differences in the incidence of a disorder can provide clues to its possible causes. For example, a population register with information gained from consensus data helps to identify all adults in a defined area who were born within a certain time period (a cohort). Cross linking this information with a mental health register for the cohort can be used to identify people who received treatment for schizophrenia over particular times. This information provides the incidence of schizophrenia for various age groups within that cohort.

What is the evidence for differences in incidence rates according to sex?

Overall, moderate to high quality evidence finds the incidence of schizophrenia is higher in males than in females. However, this is only apparent in males up until around 40 years of age, then incidence is similar between males and females until about 50 years, then it is higher in females than males over 50 years of age. This is proposed to be due to decreasing oestrogen levels in females over time, as oestrogen is a proposed protective factor for schizophrenia.

April 2022

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