Disentangling early and late onset of psychosis in women: identifying new targets for treatment

Díaz-Pons, Alexandre; González-Rodríguez, Alexandre; Foz, Víctor Ortiz‐García de la; Seeman, Mary V.; Crespo‐Facorro, Benedicto; Ayesa-Arriola, Rosa

doi:10.1007/s00737-022-01210-2

Cited by 4 publications

(3 citation statements)

References 38 publications

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“…In addition, currently operating FEP services could inform general community mental health centers through joint educational activities, case management, and ad hoc consultations. The evolution of FEP services to accommodate women’s care needs is possible only by involving all relevant stakeholders: female users with lived experience, service providers, and potential referrers such as general practitioners, maternity clinics, women’s shelters, and abuse survivors centers (González-Rodríguez et al 2020 ; Ferrara and Srihari 2021 ; Diaz-Pons et al 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Sex differences in schizophrenia-spectrum diagnoses: results from a 30-year health record registry

Ferrara,

Curtarello,

Gentili

et al. 2023

Arch Womens Ment Health

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This study investigated sociodemographic and clinical differences between the sexes in individuals affected by schizophrenia-spectrum disorders (SSD) who accessed outpatient mental health services. Within a retrospective cohort of 45,361 outpatients receiving care in Ferrara (Italy) from 1991 to 2021, those with a SSD diagnosis were compared between the sexes for sociodemographic and clinical characteristics before and after the index date (when the ICD-9: 295.*diagnosis was first recorded) to assess early trajectory, age and type of diagnosis, and severity of illness indicated by medication use, hospitalization, and duration of psychiatric care. Predictors of discharge were also investigated. Among 2439 patients, 1191 were women (48.8%). Compared to men, women were significantly older at first visit (43.7 vs. 36.8 years) and at index date (47.8 vs. 40.6) with peak frequency at age 48 (vs. 30). The most frequent last diagnosis recorded before the index date was delusional disorder (27.7%) or personality disorder (24.3%) in men and depression (24%) and delusional disorder (30.1%) in women. After the index date, long-acting antipsychotics and clozapine were more frequently prescribed to men (46.5% vs. 36.3%; 13.2% vs. 9.4%, p < 0.05) and mood stabilizers and antidepressants to women (24.3% vs. 21.1%; 50.1% vs. 35.5%; p < 0.05). Women had fewer involuntary admissions (10.1% vs. 13.6%) and were more likely to be discharged as the time under care increased (p = 0.009). After adjusting for covariates, sex was not a significant predictor of discharge. Our study confirmed that sex differences exist in clinical and sociodemographic characteristics of outpatients with SSD and that gender considerations might influence the rapidity of diagnosis and medications prescribed. These findings highlight the need to implement a women-tailored approach in specialist care programs for psychoses.

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Section: Discussionmentioning

confidence: 99%

Sex differences in schizophrenia-spectrum diagnoses: results from a 30-year health record registry

Ferrara,

Curtarello,

Gentili

et al. 2023

Arch Womens Ment Health

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“…An alternative theory that could explain the data found in this article is related to the age of symptoms onset. The earlier onset of the disease in men [10,47], up to six years according to Seeman (2012) [46], would make it more likely for them to reside in their parents' home during their debut and therefore have more family support. In contrast, women, with an increase in the age of symptom onset, would have a higher probability of having moved out before their debut, which could explain less daily contact with their family network.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to CD, further sex differences have been broadly reported regarding other psychosis-related factors such as the age of onset [ 10 ], psychosocial stressors [ 11 ], clinical presentation [ 12 ], and caregiving responsibilities [ 13 ] among others. Research has shown that men are subject to more consistent and severe criticism from their families, which in turn increases the likelihood of relapses and unfavorable disease outcomes.…”

Section: Introductionmentioning

confidence: 99%

A Proxy Approach to Family Involvement and Neurocognitive Function in First Episode of Non-Affective Psychosis: Sex-Related Differences

Soler-Andrés,

Díaz-Pons,

Ortiz-García de la Foz

et al. 2023

Healthcare

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Schizophrenia spectrum disorders (SSD) often show cognitive deficits (CD) impacting daily life. Family support has been shown to be protective against CD, yet the relationship between these in psychotic patients remains complex and not fully understood. This study investigated the association between a subdomain of family support, namely, family involvement (estimated through a proxy measure), cognitive functioning, and sex in first-episode psychosis (FEP) patients. The sample included 308 patients enrolled in the Program for Early Phases of Psychosis (PAFIP), divided into 4 groups based on their estimated family involvement (eFI) level and sex, and compared on various variables. Women presented lower rates of eFI than men (37.1% and 48.8%). Higher eFI was associated with better cognitive functioning, particularly in verbal memory. This association was stronger in women. The findings suggest that eFI may be an important factor in FEP patients’ cognitive functioning. This highlights the importance of including families in treatment plans for psychotic patients to prevent CD. Further research is needed to better understand the complex interplay between family support, sex, and cognitive functioning in psychotic patients and develop effective interventions that target these factors.

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Schizophrenia in Women

Seeman

2023

Psychiatric Clinics of North America

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Disentangling early and late onset of psychosis in women: identifying new targets for treatment

Cited by 4 publications

References 38 publications

Sex differences in schizophrenia-spectrum diagnoses: results from a 30-year health record registry

Sex differences in schizophrenia-spectrum diagnoses: results from a 30-year health record registry

A Proxy Approach to Family Involvement and Neurocognitive Function in First Episode of Non-Affective Psychosis: Sex-Related Differences

Schizophrenia in Women

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