Ar Razi Hospital study shows gender gap in schizophrenia admissions

Between 2011 and 2024, the Ar Razi university psychiatric hospital in Salé recorded 13,564 admissions for schizophrenia, with men accounting for 77.3 percent of the total, according to an analysis published in the review Dialogues in Health. The study documents 10,488 male admissions compared to 3,076 female admissions, establishing an overall ratio of 3.41 male admissions for every female admission over the fourteen-year period.

What the Admission Registers Reveal About Gender Disparities

The gender gap in schizophrenia admissions at Ar Razi remains consistent across various years rather than reflecting a single anomalous period. According to the study authored by Fatima Zahra Kessam and co-researchers from Ibn Tofail University in Kenitra alongside researchers affiliated with Ar Razi, the annual ratio between male and female admissions ranged from a low of 2.32 in 2018 to a high of 4.59 in 2011. At no point during the study timeframe did the ratio drop below two.

Researchers caution that the figures reflect hospital admissions rather than distinct individual patients, meaning a single individual can appear in the registers across multiple years. The data originates from a single facility and depicts institutional utilization rather than the prevalence or incidence of schizophrenia within the Moroccan population.

Extreme age cohorts further widen the disparity observed in the hospital logs. Among patients aged zero to fourteen, 229 out of 230 admissions—99.6 percent—involve boys. In the cohort aged 61 years and older, 325 out of 358 admissions, or 90.8 percent, involve men. The core demographic of individuals aged 15 to 60 accounts for 95.7 percent of all admissions.

The study explores whether the stark numerical difference indicates that women are genuinely less affected by schizophrenia or if they simply experience under-hospitalization. The authors note that the social stigma surrounding mental illness, particularly among women, is well-documented in Morocco. Families often manage female patients at home to shield them from societal consequences that could diminish marriage prospects.

Clinical presentation also plays a role in admission patterns. Male patients frequently exhibit more externalized symptoms that readily trigger a formal hospital admission. Conversely, clinical presentations in women often feature affective symptoms that may be misattributed to mood disorders rather than schizophrenia. Investigators stress that these hypotheses remain unconfirmed and that only a comprehensive general population survey can clarify whether women experience lower rates of the illness or merely encounter barriers to institutional care. For young girls aged zero to fourteen, the researchers also raise the possibility of a gender-based referral bias.

Fluctuations in Annual Admission Volumes

Annual intake volumes at the Salé facility fluctuated significantly between 2011 and 2024. Admissions dropped from 1,230 in 2011 to 840 in 2013—a decline of nearly one-third over two years—before recovering to 1,030 in 2016.

A sharper disruption occurred in 2020, when the hospital registered 616 admissions, representing a 41.1 percent decrease compared to the 1,046 admissions recorded in 2019. This drop coincided with the onset of the COVID-19 pandemic, though the study authors note their dataset contains no direct metrics regarding service availability to establish direct causality. The baseline data also shows prior unexplained drops of 22.8 percent in 2012 and 11.6 percent in 2013.

Following the 2020 low, admission volumes rebounded sharply. Intake rose by 36.7 percent in 2022 and by another 26.7 percent in 2023, reaching 1,226 admissions—just four units shy of the 2011 volume. The hospital logged 1,196 admissions in 2024.

Admission Volumes Depend on Institutional Policies and Bed Capacities

The study highlights that admission volumes depend heavily on institutional admission policies, available bed capacities, and patient referral pathways. Of the 13,564 total admissions, 8,536 entries—or 62.9 percent—involved patients already known to the hospital for the same condition, while 5,028 entries represented first-time presentations.

Based on these findings, the authors outline three main priorities: establishing contingency plans to maintain care continuity during future health emergencies, planning staffing levels and bed allocations in tertiary psychiatric centers to address the 2023–2024 rebound, and launching public awareness campaigns focused on women and girls. The researchers emphasize that these recommendations require validation through multicenter studies before they can guide national health policies.

Significant gaps remain in the available data. The study contains no metrics regarding operating costs, lengths of stay, total bed capacity, or funding streams, leaving the financial impact of the post-pandemic patient surge unmeasured.