Edad de inicio del primer episodio psicótico: ¿hay diferencias clínicas entre varones y mujeres?

INTRODUCTION: In the past decade, studies of first psychotic episodes have become increasingly important. In the present study, we analyzed gender differences in age of onset, as well as differences in the type and severity of psychotic symptoms according to age of onset, in men and women with a first psychotic episode. MATERIAL AND METHOD: We performed a cross-sectional study of 24 consecutive patients with a first psychotic episode. Inclusion criteria consisted of two or more psychotic symptoms, age from 7 to 65 years, first visit to a center participating in the study, and a less than 6-month time lapse since the first contact with services. The instruments used were a clinical and sociodemographic questionnaire, the Positive and Negative Syndrome Scale (PANSS) and the Clinical Global Impression-Schizophrenia (CGI-SCH) scale. Data were analyzed using the Mann-Whitney U-test for non-parametric data with the SPSS statistical package. RESULTS: In our sample, 66.7% of the sample were male and 41.7% were < 18 years old. No significant gender differences in age at onset of a first psychotic episode were observed (p = 0.580). Significant differences were obtained in the excitative dimension (p = 0.015) and a tendency was found in the positive dimension of the PANSS (p = 0.079) between adult males and adolescents. Significant differences were also found between adult males and adolescents in the negative PANSS items: emotional withdrawal (p = 0.021) and poor rapport (p = 0.036); however only a tendency towards significance was found in the negative dimension of the PANSS (p = 0.080) between adolescent males and adults. CONCLUSIONS: A pattern of onset of first psychotic episodes emerged in male adolescents with a predominance of negative symptoms. This pattern of onset with negative symptoms can be added to the evidence found in other studies over the years supporting the neurodevelopment hypothesis.