scholarly journals Gender Differences in Schizophrenia and First-Episode Psychosis: A Comprehensive Literature Review

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Susana Ochoa ◽  
Judith Usall ◽  
Jesús Cobo ◽  
Xavier Labad ◽  
Jayashri Kulkarni
Keyword(s):  
Gender Differences ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Familial Risk ◽  
First Episode Psychosis ◽  
First Episode ◽  
Neuropsychological Profile ◽  
Affective Symptoms ◽  
Episode Psychosis ◽  
Premorbid Functioning

Recent studies have begun to look at gender differences in schizophrenia and first-episode psychosis in an attempt to explain the heterogeneity of the illness. However, a number of uncertainties remain. This paper tries to summarize the most important findings in gender differences in schizophrenia and first-psychosis episodes. Several studies indicate that the incidence of schizophrenia is higher in men. Most of the studies found the age of onset to be earlier in men than in women. Findings on symptoms are less conclusive, with some authors suggesting that men suffer more negative symptoms while women have more affective symptoms. Premorbid functioning and social functioning seem to be better in females than males. However, cognitive functioning remains an issue, with lack of consensus on differences in neuropsychological profile between women and men. Substance abuse is more common in men than women with schizophrenia and first-episode psychosis. In terms of the disease course, women have better remission and lower relapse rates. Lastly, there is no evidence of specific gender differences in familial risk and obstetric complications. Overall, gender differences have been found in a number of variables, and further study in this area could help provide useful information with a view to improving our care of these patients.

Gender differences in first-episode psychosis at 5-year follow-up – two different courses of disease? Results from the OPUS study at 5-year follow-up

2014 ◽  
Vol 29 (1) ◽  
pp. 44-51 ◽  
Author(s):  
A. Thorup ◽  
N. Albert ◽  
M. Bertelsen ◽  
L. Petersen ◽  
P. Jeppesen ◽  
...  
Keyword(s):  
Gender Differences ◽  
Substance Abuse ◽  
Social Functioning ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Intervention Programme ◽  
Episode Psychosis ◽  
Symptom Patterns

AbstractObjectiveGender differences in psychosis have been investigated, and the results have contributed to a better understanding of the disease, but many questions are unanswered. In clinical terms, women and men with psychosis differ in terms of access to social support, tendency of substance abuse, level of functioning and symptom patterns. We aimed to investigate how gender differences at onset of psychosis develop during the first 5 years of treatment.MethodA total of 578 patients with a first-episode psychosis in the schizophrenia spectrum were included in the Danish OPUS trial – a randomized clinical trial comparing 2 years of intensive early-intervention programme with standard treatment. All patients were assessed with validated instruments at inclusion, and after 2 and 5 years. Data were analysed for significant gender differences.ResultsMales have significantly higher levels of negative symptoms at all times, and are more likely to live alone and suffer from substance abuse. Females reach higher levels of social functioning at follow-up, and show a greater tendency to be employed or in education than males. Markedly more women than men live with children. More women than men reach a state of recovery and are more compliant with medication.ConclusionThere are significant gender differences at 2- and 5-year follow-up in this large cohort of first-episode psychotic patients. Males and females show different symptomatology and different levels of social functioning.

scholarly journals Premorbid adjustment in first-episode non-affective psychosis: Distinct patterns of pre-onset course

2004 ◽  
Vol 185 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Tor K. Larsen ◽  
Svein Friis ◽  
Ulrik Haahr ◽  
Jan Olav Johannessen ◽  
Ingrid Melle ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Affective Psychosis ◽  
Premorbid Adjustment ◽  
Episode Psychosis ◽  
Premorbid Functioning ◽  
Shed Light

BackgroundKnowledge about premorbid development in psychosis can shed light upon theories about aetiology and schizophrenic heterogeneity, and form a basis for early detection initiatives.AimsTo identify and validate patterns of premorbid functioning in first-episode psychosis.MethodThe Premorbid Adjustment Scale was used to examine 335 patients.ResultsSocial and academic function constituted fairly independent dimensions. Cluster analysis identified groups varying both in level and course. Patients with a stable social course compared with a deteriorating one had a shorter duration of untreated psychosis, were older, had more friends and less negative symptoms. Good childhood academic function correlated with more education, more meaningful activities and better working memory. Patients with a stable academic course were older at admission.ConclusionsPatterns of premorbid development suggest both neuro-developmental and neuroregressive pathways to illness.

scholarly journals Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042949
Author(s):  
Jessica Irving ◽  
Craig Colling ◽  
Hitesh Shetty ◽  
Megan Pritchard ◽  
Robert Stewart ◽  
...  
Keyword(s):  
Gender Differences ◽  
Substance Use ◽  
Language Processing ◽  
Negative Symptoms ◽  
Clinical Presentation ◽  
First Episode Psychosis ◽  
First Episode ◽  
Illicit Substance ◽  
Illicit Substance Use ◽  
Episode Psychosis

ObjectiveTo determine whether gender differences in symptom presentation at first episode psychosis (FEP) remain even when controlling for substance use, age and ethnicity, using natural language processing applied to electronic health records (EHRs).Design, setting and participantsData were extracted from EHRs of 3350 people (62% male patients) who had presented to the South London and Maudsley NHS Trust with a FEP between 1 April 2007 and 31 March 2017. Logistic regression was used to examine gender differences in the presentation of positive, negative, depressive, mania and disorganisation symptoms.Exposure(s) (for observational studies)Gender (male vs female).Main outcome(s) and measure(s)Presence of positive, negative, depressive, mania and disorganisation symptoms at initial clinical presentation.ResultsEight symptoms were significantly more prevalent in men (poverty of thought, negative symptoms, social withdrawal, poverty of speech, aggression, grandiosity, paranoia and agitation). Conversely, tearfulness, low energy, reduced appetite, low mood, pressured speech, mood instability, flight of ideas, guilt, mutism, insomnia, poor concentration, tangentiality and elation were more prevalent in women than men. Negative symptoms were more common among men (OR 1.85, 95% CI 1.33 to 2.62) and depressive and manic symptoms more common among women (OR 0.30, 95% CI 0.26 to 0.35). After adjustment for illicit substance use, the strength of associations between gender and negative, manic and depression symptoms increased, whereas gender differences in aggression, agitation, paranoia and grandiosity became insignificant.ConclusionsThere are clear gender differences in the clinical presentation of FEP. Our findings suggest that gender can have a substantial influence on the nature of clinical presentation in people with psychosis, and that this is only partly explained by exposure to illicit substance use.

The dimensional structure of first episode psychosis: an exploratory factor analysis

1998 ◽  
Vol 28 (4) ◽  
pp. 935-947 ◽  
Author(s):  
P. D. McGORRY ◽  
R. C. BELL ◽  
P. L. DUDGEON ◽  
H. J. JACKSON
Keyword(s):  
Factor Analysis ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Dimensional Structure ◽  
First Episode ◽  
Factor Solution ◽  
Full Spectrum ◽  
Functional Psychosis ◽  
Affective Symptoms ◽  
Episode Psychosis

Background. Recent research has focused upon the subdiagnostic level in an effort to derive more valid domains of psychotic disorder. This has led to the influential positive–negative dichotomy in schizophrenia being superseded by a three-syndrome model. The strategy of looking for syndromes within poorly validated diagnostic categories, such as schizophrenia, has limitations, particularly since it originated in, and has been largely restricted to, the more chronic subsamples.Method. A representative sample of first episode psychosis (N=509), which includes the full spectrum of functional psychosis, was utilized to re-examine the dimensional structure of functional psychosis from first principles. Patients were assessed with the Royal Park Multidiagnostic Instrument for Psychosis (MIP), a comprehensive procedure that documents the psychopathology of the first episode in a clinically valid manner.Results. Principal axis factor analysis was carried out on the tetrachoric correlation matrix of 92 core psychopathological items. A robust and clinically valid four-factor solution was obtained, comprising depression, mania and only two other factors. The first was a Bleulerian blend of negative symptoms, catatonic/motor symptoms and disorganization. The second was a combination of Schneiderian first rank symptoms, and other hallucinations and delusions. The data thus failed to support the three-syndrome model for non-affective symptoms in this population. A six-factor solution, although partially consistent with other studies, represented a more complex and confusing elaboration of the more clinically valid four-factor solution.Conclusions. The findings have implications for the conceptualization of early psychosis, which need to be explored further in validation studies.

Gender differences in response to metacognitive training in people with first-episode psychosis.

2020 ◽  
Vol 88 (6) ◽  
pp. 516-525 ◽  
Author(s):  
Miriam Salas-Sender ◽  
Raquel López-Carrilero ◽  
Ana Barajas ◽  
Esther Lorente-Rovira ◽  
Esther Pousa ◽  
...  
Keyword(s):  
Gender Differences ◽  
First Episode Psychosis ◽  
First Episode ◽  
Metacognitive Training ◽  
Episode Psychosis

Conceptual disorganization and redistribution of resting state cortical hubs in untreated first episode psychosis: A 7T MRI study

2020 ◽  
Author(s):  
Avyarthana Dey ◽  
Kara Dempster ◽  
Michael Mackinley ◽  
Peter Jeon ◽  
Tushar Das ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Superior Temporal Gyrus ◽  
Brain Regions ◽  
First Episode Psychosis ◽  
Cortical Reorganization ◽  
First Episode ◽  
Formal Thought Disorder ◽  
Whole Brain ◽  
Episode Psychosis ◽  
Positive And Negative Symptoms

Background:Network level dysconnectivity has been studied in positive and negative symptoms of schizophrenia. Conceptual disorganization (CD) is a symptom subtype which predicts impaired real-world functioning in psychosis. Systematic reviews have reported aberrant connectivity in formal thought disorder, a construct related to CD. However, no studies have investigated whole-brain functional correlates of CD in psychosis. We sought to investigate brain regions explaining the severity of CD in patients with first-episode psychosis (FEPs) compared with healthy controls (HCs).Methods:We computed whole-brain binarized degree centrality maps of 31 FEPs, 25 HCs and characterized the patterns of network connectivity in the two groups. In FEPs, we related these findings to the severity of CD. We also studied the effect of positive and negative symptoms on altered network connectivity.Results:Compared to HCs, reduced hubness of a right superior temporal gyrus (rSTG) cluster was observed in the FEPs. In patients exhibiting high CD, increased hubness of a medial superior parietal (mSPL) cluster was observed, compared to patients exhibiting low CD. These two regions were strongly correlated with CD scores but not with other symptom scores.Discussion:Our observations are congruent with previous findings of reduced but not increased hubness. We observed increased hubness of mSPL suggesting that cortical reorganization occurs to provide alternate routes for information transfer.Conclusion:These findings provide insight into the underlying neural processes mediating the presentation of symptoms in untreated FEP. A longitudinal tracking of the symptom course will be useful to assess the mechanisms underlying these compensatory changes.

scholarly journals Patterns and predictors of hospitalisation in first-episode psychosis

2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh
Keyword(s):  
Negative Symptoms ◽  
First Episode Psychosis ◽  
Psychiatric Services ◽  
First Episode ◽  
Psychotic Episode ◽  
Duration Of Untreated Illness ◽  
Specialist Services ◽  
Increased Risk ◽  
Episode Psychosis

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.

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