Skip to main content

Advertisement

SpringerLink
Log in

Gender and 5-years course of psychosis patients: focus on clinical and social variables

  • Original Article
  • Published:
Archives of Women's Mental Health Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Alda M (2013) Personalized psychiatry: many questions, fewer answers. J Psychiatry Neurosci 38(6):363–365

    Article  Google Scholar 

  • Amaddeo F, Zambello F, Tansella M, Thornicroft G (2001) Accessibility and pathways to psychiatric care in a community-based mental health system. Soc Psychiatry Psychiatr Epidemiol 36(10):500–507

    Article  CAS  Google Scholar 

  • Austin SF, Mors O, Budtz-Jorgensen E, Secher RG, Hjorthoj CR, Bertelsen M, Jeppesen P, Petersen L, Thorup A, Nordentoft M (2015) Long-term trajectories of positive and negative symptoms in first episode psychosis: a 10 year follow-up study in the OPUS cohort. Schizophr Res 168(1–2):84–91

    Article  Google Scholar 

  • Barajas A, Teixido M, San Emeterio M, Conesa E, Carbonero M, Mantecon N, Antonia Argany M, Sanchez E, Alvarez I, Franco C, Escudero A, Lalucat L (2012) Symptomatic remission in incipient psychosis at 1-year follow-up: relationship with severity of symptoms, global functioning and disability. Early Interv Psychiatry 6:80–80

    Google Scholar 

  • Bertani M, Lasalvia A, Bonetto C, Tosato S, Cristofalo D, Bissoli S, De Santi K, Mazzoncini R, Lazzarotto L, Santi M, Sale A, Scalabrin D, Abate M, Tansella M, Ruggeri M, Picos-Veneto G (2012) The influence of gender on clinical and social characteristics of patients at psychosis onset: a report from the psychosis incident cohort outcome study (PICOS). Psychol Med 42(4):769–780

    Article  CAS  Google Scholar 

  • Bimbi F (2003) Differenze e disuguaglianze. Prospettive per gli studi di genere in Italia (differences and inequalities. Prospects for gender studies in Italy). Bologna: Il Mulino

  • Case M, Stauffer VL, Ascher-Svanum H, Conley R, Kapur S, Kane JM, Kollack-Walker S, Jacob J, Kinon BJ (2011) The heterogeneity of antipsychotic response in the treatment of schizophrenia. Psychol Med 41(6):1291–1300

    Article  CAS  Google Scholar 

  • Chang WC, Tang JYM, Hui CLM, Chiu CPY, Lam MML, Wong GHY, Chung DWS, Law CW, Tso S, Chan KPM, Hung SF, Chen EYH (2011) Gender differences in patients presenting with first-episode psychosis in Hong Kong: a three-year follow up study. Aust N Z J Psychiatry 45(3):199–205

    Article  Google Scholar 

  • Chang WC, Tang JYM, Hui CLM, Lam MML, Wong GHY, Chan SKW, Chiu CPY, Chung DWS, Law CW, Tso S, Chan K, Hung SF, Chen EYH (2012) Duration of untreated psychosis: relationship with baseline characteristics and three-year outcome in first-episode psychosis. Psychiatry Res 198(3):360–365

    Article  Google Scholar 

  • Cotton SM, Lambert M, Schimmelmann BG, Foley DL, Morley KI, McGorry PD, Conus P (2009) Gender differences in premorbid, entry, treatment, and outcome characteristics in a treated epidemiological sample of 661 patients with first episode psychosis. Schizophr Res 114(1–3):17–24

    Article  CAS  Google Scholar 

  • David AS (1990) Insight and psychosis. Br J Psychiatry 156:798–808

    Article  CAS  Google Scholar 

  • Green CA, Perrin NA, Leo MC, Janoff SL, Yarborough BJH, Paulson RI (2013) Recovery from serious mental illness: trajectories, characteristics, and the role of mental health care. Psychiatr Serv 64(12):1203–1210

    Article  Google Scholar 

  • Grossman LS, Harrow M, Rosen C, Faull R, Strauss GP (2008) Sex differences in schizophrenia and other psychotic disorders: a 20-year longitudinal study of psychosis and recovery. Compr Psychiatry 49(6):523–529

    Article  Google Scholar 

  • Hodgekins J, Birchwood M, Christopher R, Marshall M, Coker S, Everard L, Lester H, Jones P, Amos T, Singh S, Sharma V, Freemantle N, Fowler D (2015) Investigating trajectories of social recovery in individuals with first-episode psychosis: a latent class growth analysis. Br J Psychiatry 207(6):536–543

    Article  Google Scholar 

  • Hui C, Li A, Chang W-C, Chan S, Lee E, Chen E (2014) Gender specific correlates of neurocognition and functioning in first episode psychosis. Early Interv Psychiatry 8:74–74

    Article  Google Scholar 

  • Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, Day R, Bertelsen A (1992) Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 20:1–97

    Article  CAS  Google Scholar 

  • Karow A, Pajonk FG, Reimer J, Hirdes F, Osterwald C, Naber D, Moritz S (2008) The dilemma of insight into illness in schizophrenia: self- and expert-rated insight and quality of life. Eur Arch Psychiatry Clin Neurosci 258(3):152–159

    Article  CAS  Google Scholar 

  • Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13(2):261–276

    Article  CAS  Google Scholar 

  • Kemp R, David A (1996) Psychological predictors of insight and compliance in psychotic patients. Br J Psychiatry 169(4):444–450

    Article  CAS  Google Scholar 

  • Koster A, Lindhardt A, Lajer M, Rosenbaum B (2008) Gender differences in first episode psychosis. Soc Psychiatry Psychiatr Epidemiol 43(12):940–946

    Article  Google Scholar 

  • Lasalvia A, Tosato S, Brambilla P, Bertani M, Bonetto C, Cristofalo D, Bissoli S, De Santi K, Lazzarotto L, Zanatta G, Marrella G, Mazzoncini R, Zanoni M, Garzotto N, Dolce C, Nicolau S, Ramon L, Perlini C, Rambaldelli G, Bellani M, Tansella M, Ruggeri M, Grp PI-V (2012) Psychosis incident cohort outcome study (PICOS). A multisite study of clinical, social and biological characteristics, patterns of care and predictors of outcome in first-episode psychosis. Background, methodology and overview of the patient sample. Epidemiol Psychiatr Sci 21(3):281–303

    Article  CAS  Google Scholar 

  • Levine SZ, Rabinowitz J (2010) Trajectories and antecedents of treatment response over time in early-episode psychosis. Schizophr Bull 36(3):624–632

    Article  Google Scholar 

  • Levine SZ, Lurie I, Kohn R, Levav I (2011) Trajectories of the course of schizophrenia: from progressive deterioration to amelioration over three decades. Schizophr Res 126(1–3):184–191

    Article  Google Scholar 

  • McCrone P, Leese M, Thornicroft G, Schene AH, Knudsen HC, Vazquez-Barquero JL, Lasalvia A, Padfield S, White IR, Griffiths G, Grp ES (2000) Reliability of the Camberwell assessment of need—European version—EPSILON study 6. Br J Psychiatry 177:S34–S40

    Article  Google Scholar 

  • McEvoy JP, Johnson J, Perkins D, Lieberman JA, Hamer RM, Keefe RSE, Tohen M, Glick ID, Sharma T, Grp HR (2006) Insight in first-episode psychosis. Psychol Med 36(10):1385–1393

    Article  Google Scholar 

  • Menezes NM, Arenovich T, Zipursky RB (2006) A systematic review of longitudinal outcome studies of first-episode psychosis. Psychol Med 36(10):1349–1362

    Article  CAS  Google Scholar 

  • Mintz AR, Dobson KS, Romney DM (2003) Insight in schizophrenia: a meta-analysis. Schizophr Res 61(1):75–88

    Article  Google Scholar 

  • Ochoa S, Usall J, Cobo J, Labad X, Kulkarni J (2012) Gender differences in schizophrenia and first-episode psychosis: a comprehensive literature review. Schizophr Res Treat 2012:916198–916198

    Google Scholar 

  • Parellada M, Boada L, Fraguas D, Reig S, Castro-Fornieles J, Moreno D, Gonzalez-Pinto A, Otero S, Rapado-Castro M, Graell M, Baeza I, Arango C (2011) Trait and state attributes of insight in first episodes of early-onset schizophrenia and other psychoses: a 2-year longitudinal study. Schizophr Bull 37(1):38–51

    Article  Google Scholar 

  • Penttilä M, Jääskeläinen E, Hirvonen N, Isohanni M, Miettunen J (2014) Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis. Br J Psychiatry 205(2):88–94

    Article  Google Scholar 

  • Rabinowitz J, Levine SZ, Haim R, Haefner H (2007) The course of schizophrenia: progressive deterioration, amelioration or both? Schizophr Res 91(1–3):254–258

    Article  Google Scholar 

  • Schennach R, Meyer S, Seemueller F, Jaeger M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkoetter J, Heuser I, Maier W, Lemke MR, Ruether E, Klingberg S, Gastpar M, Musil R, Moeller H-J, Riedel M (2012) Response trajectories in “real-world” naturalistically treated schizophrenia patients. Schizophr Res 139(1–3):218–224

    Article  Google Scholar 

  • Thorup A, Petersen L, Jeppesen P, OhlenschIceger J, Christensen T, Krarup G, Jorgensen P, Nordentoft M (2007) Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study. J Nerv Ment Dis 195(5):396–405

    PubMed  Google Scholar 

Download references

Funding

This study was supported by the Ricerca Sanitaria Finalizzata 2004, Giunta Regionale del Veneto with a grant to Prof M. Ruggeri, Ricerca Sanitaria Finalizzata 2005, Giunta Regionale del Veneto with a grant to Dr. A. Lasalvia, and by the Fondazione Cariverona, which provided a 3-year grant to the WHO Collaborating Centre for Research and Training in Mental Health and Service Organization at the University of Verona, directed by Prof M. Tansella. The grant (“Promoting research to improve quality of care. The Verona WHO Centre for mental health research”) supports the main research projects of the following Units of the Verona WHO Centre: Psychiatric Case Register, Geographical Epidemiology and Mental Health Economics (Head: Prof F. Amaddeo); Clinical Psychopharmacology & Drug Epidemiology (Head: Dr. C. Barbui); and Environmental, Clinical and Genetic Determinants of Outcome of Mental Disorders (Head: Prof M. Ruggeri).

Author information

Authors and Affiliations

  1. Department Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy

    Carla Comacchio, Antonio Lasalvia, Chiara Bonetto, Doriana Cristofalo, Elisabetta Miglietta, Sara Petterlini, K. De Santi, S. Tosato, R. Riolo, C. Cremonese, E. Ceccato, G. Zanatta & Mirella Ruggeri

Authors
  1. Carla Comacchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Lasalvia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Bonetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Doriana Cristofalo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elisabetta Miglietta
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sara Petterlini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K. De Santi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Tosato
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. R. Riolo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. C. Cremonese
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. E. Ceccato
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. G. Zanatta
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Mirella Ruggeri
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

the PICOS Veneto Group

Corresponding author

Correspondence to Carla Comacchio.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix

Appendix

The PICOS-Veneto Group Coordinating staff:

M. Tansella, M. Ruggeri, A. Lasalvia, M. Bertani, C. Bonetto, P. Brambilla, S. Tosato, D. Cristofalo, G. Marrella, S. Bissoli, and C. Perlini.

Collaborating sites:

Bassano del Grappa: P. Tito, M. Lunardon, F. Gava, E. Borso, L. Grandina, M. Paliotto, L. Roggia. Thiene: A. Danieli, C. Poloni, M. R. Altiero, F. Piazza. Monteccchio M.: E. Ceccato, C. Busana, A. Campi, A. Zanconato. Vicenza 1 UO: P. Zamorani, R. Binotto, A. Caneva, E. Lazzarin, G. Zordan. Vicenza 2 UO: C. Dolce, G. B. Fanchin, C. Negro. Vicenza 3 UO: F. Gardellin, M. Crestale, L. Paiola, A. Sale. Pieve di Soligo: I. Morandin, E. Biondi, A. Cordella G. Favaretto, S. Geatti, P. Urbani. Treviso:M. De Rossi, G. Zanatta, J. Spessotto, R. Penelope, L. Grando, M. Sgnaolin, C. Tozzini, G. Visentin, L. Schiavon. Portogruaro: B. Gentile, M. G. Bolacchi, L. Marzotto, F. Moni, L. Rossi. San Dona` di Piave: I. Amalric, C. Miceli, M. R. De Zordo, L. Ramon, S. Russo. Venezia: R. Rossi, G. Casagrande, V. De Nardo, A. Facchetti, F. Ramaciotti. Mirano: V. Marangon, G. Coppola, A. Marcolin, P. Meneghini, F. Sbraccia, C. Segato. Camposampiero: R. Riolo, L. Cappellari, M. Cutugno, L. Meneghetti, L. Longhin, B. Paoleschi. Cittadella: D. Scalabrin, L. Antonello, A. Purgato, G. Santucci, C. Tosin, R. Volpato, R. Zurlo. Padova 2 Serv: M. Zucchetto, M. Pedron, S. Pinton, M. Benetazzo. Padova 3 Serv: C. Cremonese, L. Pavan, M. Semenzin, L. Sifari, F. Zorzi. Rovigo: M. M. Martucci, N. Magno, G. Meloni, E. Toniolo. Adria: M. Pavanati, E. Destro, L. Finotti. Verona 1 Serv: R. Fiorio, A. Marsilio, N. Pedrocco, P. Pollola. Verona 2 Serv: L. Lazzarotto, F. Nose`, P. Rossin, V. Vivenza. Verona 3 Serv: A. Lasalvia, M. Bertani, S. Bissoli, K. De Santi, G. Marrella, R. Mazzoncini, M. Ruggeri. Verona 4 Serv: A. Urbani, L. Bianchi, G. Carcereri, L. Lunardi, G. Migliorini, G. Perdona`, C. Piazza. Legnago: D. Lamonaca, G. D’Agostini, I. Boggian, G. Piccione, E. Saladini. Domegliara: F. Gomez, S. Frazzingaro. Isola della Scala: S. Nicolaou, L. Cordioli, G. Bertolazzi, V. Pagliuca. Villa Santa Chiara: M. Abate, M. Bortolomasi, M. Giacopuzzi, M. Segala. Villa Santa Giuliana: F. De Nardi, F. Basetto, C. Bernardis, A. Bezzetto, M. Santi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Comacchio, C., Lasalvia, A., Bonetto, C. et al. Gender and 5-years course of psychosis patients: focus on clinical and social variables. Arch Womens Ment Health 23, 63–70 (2020). https://doi.org/10.1007/s00737-019-0945-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00737-019-0945-3

Keywords

Search

Navigation