Gender differences in incipient psychosis

Background and Objectives: To describe gender differences in a group of patients with first-episode psychotic in different aspects: socio-demographic features, characteristics of the phases prior to disease onset (premorbid and prodromic periods), clinical manifestation of psychotic symptoms and possible corresponding cognitive alterations after disease onset, using the age at onset of first psychotic episode as a control variable. Methods: Longitudinal study of 53 consecutive cases with a first psychotic episode. Inclusion criteria: two or more psychotic symptoms; age between 7 to 65 years old; first consultation to the medical center of study; less than 6 months since the first contact to the medical service; and less than a year of symptoms' evolution. The methodologic assessment includes: a socio-demographic questionnaire and an extensive battery of tests to assess premorbid/prodromic, clinical and cognitive characteristics. We perform mean differences tests to analyze continuous variables (non-parametric U-Mann-Whitney and t-Student test) and chi-square test for categorical variables (SPSS 16.0). Results: In the group of patients under 18 years, men showed higher scores in adjustment premorbid (U = 54.0, p = 0.050), more neurological soft signs (U = 31.0 p = 0.003), more negative psychotic symptoms (U = 48.5, p = 0.051) and worse insight (U = 30.0, p = 0.003) than women (after 8 weeks of psychotic episode onset). Conclusions: We found gender differences in most of the variables analyzed when age at onset was controlled. These differences should be taken into account to learn more about the different types of onset of the disease, its prevention and possible improvements in therapeutic approach. Our findings suggest that younger men with an earlier onset of psychotic episode have more alterations in the stages prior to the onset of the disease supporting the neurodevelopmental hypothesis for gender differences.