Gender identity disorders as a secondary symptom of psychosis, and in particular, schizophrenia (original) (raw)
Related papers
Australian & New Zealand Journal of Psychiatry, 2011
Objective: The aim of the current study was to investigate gender differences with respect to pre-treatment characteristics, clinical presentation, service utilization and functional outcome in patients presenting with first-episode psychosis.Methods: A total of 700 participants (men, n = 360; women, n = 340) aged 15 to 25 years consecutively enrolled in a territory-wide first-episode psychosis treatment programme in Hong Kong from July 2001 to August 2003 were studied. Baseline and three-year follow up variables were collected via systematic medical file review.Results: At service entry, men had significantly lower educational attainment (p < 0.01), longer median duration of untreated psychosis (p < 0.001), fewer past suicidal attempts (p < 0.01), more severe negative symptoms (p < 0.05) and fewer affective symptoms (p < 0.01) than women. There was no significant gender difference in age of onset. In three-year follow up, men had more prominent negative symptoms (p &...
Early Intervention in Psychiatry, 2015
Aims: This study aimed to identify the gender differences among multiethnic, Asian patients with firstepisode psychosis attending the Early Psychosis Intervention Programme (EPIP) in Singapore. Methods: Data for this study were derived from 533 (258 female, 275 male) patients aged 16-41 years old in the EPIP database. Sociodemographic data, Positive and Negative Syndrome Scale for schizophrenia (PANSS) and Global Assessment of Functioning (GAF) scores at baseline, 3 months, 6 months and 1 year were obtained. Results: Significant gender differences were identified in terms of age, marital status, referral source, PANSS scores, GAF scores, remission and recovery over 1 year in the cohort. At service entry, female participants were older, more likely to be married and more likely to be referred from general practitioner/polyclinics (P < 0.0001). They showed better improvement over 1 year in PANSS positive, PANSS total, GAF disability and GAF total scores. Conclusions: Overall, female participants in this sample show better improvement than male participants. They showed a better course of illness over 1 year with one-third (33.3%) of female participants achieving recovery compared with approximately a quarter (23.6%) of male participants.
When does experience of psychosis result in a need for care? (NEMESIS)
Acta Psychiatrica Scandinavica, 2002
Objective It is suggested that the duration of untreated psychosis (DUP) is directly correlated to the outcome of the illness. This study examines the effect of DUP on the acute response of patients with first-episode psychosis. Method In this naturalistic study, 55 Asian patients with firstepisode psychosis were assessed weekly for 6 weeks on the Positive and Negative Syndrome Scale (PANSS), Simpson-Angus Rating Scale, Barnes Akathisia Rating Scale and the Abnormal Involuntary Movement Scale. Clinical response was defined as a 20% or greater reduction in PANSS from baseline. Results After 6 weeks, the response rate was 67% (n ¼ 37). The responders had a mean DUP of 14.7 ± 20.2 months and a median of 6 months. This was significantly shorter when compared to the mean DUP 37.3 (SD ¼ 32.7) months, median of 36 months of the nonresponders (Mann-Whitney U-test, P ¼ 0.37). There was no significant difference in the mean daily dose of antipsychotics, the mean Simpson-Angus Scale, the Barnes Akathisia Scale and the Abnormal Involuntary Movement Scale scores between the responders and nonresponders. Conclusions The study results suggest that DUP is a predictor of acute response in first episode psychosis.
One-year stability of diagnosis in first-episode nonaffective psychosis: influence of sex
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2006
To determine whether sex influences the frequency and direction of diagnostic change 1 year after a first episode of nonaffective psychosis. The subjects (n = 228) were individuals diagnosed with schizophrenia and other psychoses according to DSM-IV criteria at baseline and at 1 year. When diagnostic shifts occurred, men mainly shifted toward schizophrenia (84.6%), which was associated with more severe symptoms. In contrast, 72% of women in whom a diagnostic shift occurred shifted away from a schizophrenia spectrum disorder toward mood disorder. A shift to mood disorder in women was associated with an early age of illness onset. At initial presentation, nonaffective first-episode psychosis studies may underestimate the number of men and overestimate the number of women who will eventually receive a schizophrenia diagnosis.
Schizophrenia Research and Treatment, 2012
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.
Psychiatry Research, 2012
First-episode psychosis Outcome Employment Mode of onset Duration of untreated psychosis (DUP) has been considered as one of the few potentially malleable prognostic factors in psychotic illness. The literature demonstrated that prolonged DUP predicted the level of positive symptoms, but its relationships with negative symptoms and functional outcome were less clear-cut. Thus far, most first-episode studies have been conducted in western countries. Yet, it is known that illness outcome might be modified by socio-cultural factors. In this study, we aimed to examine the impact of DUP on baseline characteristics, clinical and vocational outcomes over 3 years in 700 Chinese young people who presented with first-episode psychosis to a specialized early intervention service in Hong Kong. Our results showed that prolonged DUP was associated with male sex, younger age of onset, schizophrenia-spectrum diagnosis, insidious development of psychosis, fewer baseline positive symptoms and less likelihood of hospitalization at intake. Regression analyses revealed that prolonged DUP was significantly predictive of outcome on positive symptoms, recovery and sustained full-time employment in our first-episode psychosis cohort. Taken together, our study provided further supportive evidence regarding the prognostic value of DUP on illness outcome. Additionally, it suggested that an adverse impact of treatment delay for psychosis may likely be applied across regions of various ethno-cultural backgrounds.
Gender and 5-years course of psychosis patients: focus on clinical and social variables
Archives of Women's Mental Health, 2019
Most studies on gender and psychosis have focused on gender differences at illness onset or on the long-term outcome, whereas little is known about the impact of gender on the first years after psychosis onset. A total of 185 first episode psychosis (FEP) patients were followed for 5 years after psychosis onset, and gender differences were explored in psychopathology (PANSS), needs for care (CAN), and insight (SAI-E). Male patients showed more negative symptoms than females over time, whereas female patients showed higher levels of depressive symptoms than males throughout the study period. In addition, female patients presented more functioning unmet needs for care, but higher levels of insight into illness than males. Therapy and rehabilitative programs for FEP patients should be gender-targeted, as gender has proved to impact on psychopathology, needs for care, and insight in the very first years following psychosis onset.