Gender differences in symptoms, functioning and social support in patients at ultra-high risk for developing a psychotic disorder

Abstract

Gender differences have been widely observed in the clinical presentation, psychosocial functioning and course of illness in first-episode and chronic patients suffering from schizophrenia. However, little is known about gender differences in the psychosis prodrome. This study investigated gender differences in symptoms, functioning and social support in individuals at ultra-high-risk for developing a psychotic disorder. Sixty-eight ultra-high-risk patients were assessed at baseline, and twenty-seven returned for follow-up assessments approximately 6 and 12 months later. Clinical symptoms and functioning were assessed by clinical interview; social support was measured using a self-report questionnaire. There were no gender differences in demographic variables, symptoms or functioning at baseline. Males were found to have significantly higher levels of negative symptoms and marginally lower levels of functioning when baseline and follow-up time points were considered collectively. Additionally, females reported higher levels of social support at baseline. Differences in negative symptoms were found to mediate differences in functioning between male and female patients. This study suggests that gender based differences in symptom presentation and functional outcome may predate conversion to psychosis. Follow-up studies should examine the relationship between symptoms, functioning and social support in this population.

Figure 1. Negative Symptoms over Time in Male and Female Patients

Total ratings of negative symptoms were obtained by adding all the ratings across six separate questions on the SIPS, thus the range of possible total scores was 0–36. Male patients enrolled in the CAPPS program were found to have more severe levels of negative symptoms when assessed over time, than female patients. ** p < 0.05

Figure 2. Average Global Functioning over Time in Male and Female Patients

Average ratings of functioning at each time point were calculated using GAF scores from the SIPS. Female patients enrolled in the CAPPS program were found to have marginally higher levels of functioning when assessed over time, than male patients. * p < 0.10