{"title":"初发精神病的性别差异：制定针对不同性别的治疗策略的一些论据。","authors":"","doi":"10.1016/j.schres.2024.07.046","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Some aspects of gender differences in patients with schizophrenia spectrum disorders (SSD) have been studied, especially in cross-sectional designs and with a short-term follow-up. However, only a few studies have considered the evolution during the follow-up of SSD patients according to their gender. In this study, we explore gender differences from the time of entry in an early intervention program for psychosis, up to three years follow-up.</p></div><div><h3>Methods</h3><p>We conducted a prospective study including a cohort of 474 patients treated at the Treatment and Early Intervention in Psychosis (TIPP) program, 319 men and 155 women, having presented a first episode of psychosis (FEP). Data regarding premorbid and baseline sociodemographic, psychopathological and patient functioning, were collected. These data were reassessed longitudinally after 2, 6, 12, 18, 24, 30 and 36 months after entry in TIPP.</p></div><div><h3>Results</h3><p>Regarding premorbid and baseline characteristics, woman developed threshold symptoms of a FEP 1 year later than men on average. Women were more likely to be married, men were more likely to live in pension or care home facility or to be homeless. Women displayed a higher rate of history of suicide attempts and exposure to childhood trauma, while men were more likely to have a forensic history, a history of abuse of alcohol and cannabis as well as a dependency to cannabis at the time of entry in TIPP. Regarding evolution, men were more prone to violent acts and were less likely to decrease their usage of substances. The longitudinal analysis highlighted that men displayed greater negative symptoms over the entire treatment period, lower functioning after 6 months and on all assessment points after. Both genders displayed similar rate of improvement in these 3 dimensions over time.</p></div><div><h3>Conclusion</h3><p>Our study confirms that there are some gender differences in the early phase of psychosis that may require differentiation of assessment and treatment to improve recovery.</p></div>","PeriodicalId":21417,"journal":{"name":"Schizophrenia Research","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0920996424003529/pdfft?md5=fa245d4d3a1ff30e0982ddacecc9c1e9&pid=1-s2.0-S0920996424003529-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Gender differences in first episode psychosis: Some arguments to develop gender specific treatment strategies\",\"authors\":\"\",\"doi\":\"10.1016/j.schres.2024.07.046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Some aspects of gender differences in patients with schizophrenia spectrum disorders (SSD) have been studied, especially in cross-sectional designs and with a short-term follow-up. However, only a few studies have considered the evolution during the follow-up of SSD patients according to their gender. In this study, we explore gender differences from the time of entry in an early intervention program for psychosis, up to three years follow-up.</p></div><div><h3>Methods</h3><p>We conducted a prospective study including a cohort of 474 patients treated at the Treatment and Early Intervention in Psychosis (TIPP) program, 319 men and 155 women, having presented a first episode of psychosis (FEP). Data regarding premorbid and baseline sociodemographic, psychopathological and patient functioning, were collected. These data were reassessed longitudinally after 2, 6, 12, 18, 24, 30 and 36 months after entry in TIPP.</p></div><div><h3>Results</h3><p>Regarding premorbid and baseline characteristics, woman developed threshold symptoms of a FEP 1 year later than men on average. Women were more likely to be married, men were more likely to live in pension or care home facility or to be homeless. Women displayed a higher rate of history of suicide attempts and exposure to childhood trauma, while men were more likely to have a forensic history, a history of abuse of alcohol and cannabis as well as a dependency to cannabis at the time of entry in TIPP. Regarding evolution, men were more prone to violent acts and were less likely to decrease their usage of substances. The longitudinal analysis highlighted that men displayed greater negative symptoms over the entire treatment period, lower functioning after 6 months and on all assessment points after. 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引用次数: 0
摘要
简介有关精神分裂症谱系障碍（SSD）患者性别差异的某些方面已经得到了研究，尤其是在横断面设计和短期随访中。然而，只有少数研究考虑了精神分裂症谱系障碍（SSD）患者在随访过程中的性别差异。在这项研究中，我们探讨了从参加精神病早期干预项目到三年随访期间的性别差异：我们开展了一项前瞻性研究，研究对象包括 474 名在精神病治疗与早期干预项目（TIPP）中接受治疗的患者，其中男性 319 人，女性 155 人，他们都是精神病首次发作患者（FEP）。研究人员收集了发病前和基线社会人口学、精神病理学和患者功能方面的数据。在进入 TIPP 2、6、12、18、24、30 和 36 个月后，对这些数据进行了纵向重新评估：就发病前和基线特征而言，女性比男性平均晚一年出现 FEP 的阈值症状。女性更有可能已婚，男性更有可能居住在养老院或护理院设施中，或者无家可归。女性有更高比例的自杀未遂史和童年创伤史，而男性则更有可能有法医鉴定史、酗酒史和大麻滥用史，以及在进入 TIPP 时对大麻有依赖性。在进化方面，男性更容易出现暴力行为，并且不太可能减少药物的使用。纵向分析突出表明，在整个治疗期间，男性表现出更多的负面症状，6 个月后以及之后的所有评估点上，男性的功能都较低。随着时间的推移，男女在这三个方面的改善率相似：我们的研究证实，在精神病的早期阶段存在一些性别差异，可能需要区别评估和治疗，以改善康复情况。
Gender differences in first episode psychosis: Some arguments to develop gender specific treatment strategies
Introduction
Some aspects of gender differences in patients with schizophrenia spectrum disorders (SSD) have been studied, especially in cross-sectional designs and with a short-term follow-up. However, only a few studies have considered the evolution during the follow-up of SSD patients according to their gender. In this study, we explore gender differences from the time of entry in an early intervention program for psychosis, up to three years follow-up.
Methods
We conducted a prospective study including a cohort of 474 patients treated at the Treatment and Early Intervention in Psychosis (TIPP) program, 319 men and 155 women, having presented a first episode of psychosis (FEP). Data regarding premorbid and baseline sociodemographic, psychopathological and patient functioning, were collected. These data were reassessed longitudinally after 2, 6, 12, 18, 24, 30 and 36 months after entry in TIPP.
Results
Regarding premorbid and baseline characteristics, woman developed threshold symptoms of a FEP 1 year later than men on average. Women were more likely to be married, men were more likely to live in pension or care home facility or to be homeless. Women displayed a higher rate of history of suicide attempts and exposure to childhood trauma, while men were more likely to have a forensic history, a history of abuse of alcohol and cannabis as well as a dependency to cannabis at the time of entry in TIPP. Regarding evolution, men were more prone to violent acts and were less likely to decrease their usage of substances. The longitudinal analysis highlighted that men displayed greater negative symptoms over the entire treatment period, lower functioning after 6 months and on all assessment points after. Both genders displayed similar rate of improvement in these 3 dimensions over time.
Conclusion
Our study confirms that there are some gender differences in the early phase of psychosis that may require differentiation of assessment and treatment to improve recovery.
期刊介绍：
As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership!
Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue.
The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.
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