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Meta-Analysis
. 2022 Aug;25(4):679-691.
doi: 10.1007/s00737-022-01247-3. Epub 2022 Jun 24.

Sex and gender differences in symptoms of early psychosis: a systematic review and meta-analysis

Brooke Carter  1 , Jared Wootten  1 , Suzanne Archie  2 , Amanda L Terry  1   3 , Kelly K Anderson  4   5
Affiliations
Meta-Analysis

Sex and gender differences in symptoms of early psychosis: a systematic review and meta-analysis

Brooke Carter et al. Arch Womens Ment Health. 2022 Aug.

Abstract

First-episode psychosis (FEP) can be quite variable in clinical presentation, and both sex and gender may account for some of this variability. Prior literature on sex or gender differences in symptoms of psychosis have been inconclusive, and a comprehensive summary of evidence on the early course of illness is lacking. The objective of this study was to conduct a systematic review and meta-analysis of the literature to summarize prior evidence on the sex and gender differences in the symptoms of early psychosis. We conducted an electronic database search (MEDLINE, Scopus, PsycINFO, and CINAHL) from 1990 to present to identify quantitative studies focused on sex or gender differences in the symptoms of early psychosis. We used random effects models to compute pooled standardized mean differences (SMD) and risk ratios (RR), with 95% confidence intervals (CI), for a range of symptoms. Thirty-five studies met the inclusion criteria for the systematic review, and 30 studies were included in the meta-analysis. All studies examined sex differences. Men experienced more severe negative symptoms (SMD = - 0.15, 95%CI = - 0.21, - 0.09), whereas women experienced more severe depressive symptoms (SMD = 0.21, 95%CI = 0.14, 0.27) and had higher functioning (SMD = 0.16, 95%CI = 0.10, 0.23). Women also had a lower prevalence of substance use issues (RR = 0.65, 95%CI = 0.61, 0.69). Symptoms of early psychosis varied between men and women; however, we were limited in our ability to differentiate between biological sex and gender factors. These findings may help to inform early detection and intervention efforts to better account for sex and gender differences in early psychosis presentation.

Keywords: First-episode psychosis; Psychosis; Sex differences; Symptoms.

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References

    1. Alho JM (1992) On prevalence, incidence, and duration in general stable populations. Biometrics 48(2):587–592 - DOI
    1. Anderson KK, Norman R, MacDougall AG, Edwards J, Palaniyappan L, Lau C, Kurdyak P (2018) Disparities in access to early psychosis intervention services: comparison of service users and nonusers in health administrative data. Can J Psychiatry 63(6):395–403. https://doi.org/10.1177/0706743718762101 - DOI - PubMed - PMC
    1. Arnold LM, Keck PE, Collins J, Wilson R, Fleck DE, Corey KB, Amicone J, Adebimpe VR, Strakowski SM (2004) Ethnicity and first-rank symptoms in patients with psychosis. Schizophr Res 67(2):207–212. https://doi.org/10.1016/S0920-9964(02)00497-8 - DOI - PubMed
    1. Arranz S, Mané A, Bergé D, Monserrat C, Cabezas A, Vilella E, Sanchez-Gistau V (2020) The impact of sex and cannabis on clinical features in first–admitted patients with psychosis. Eur Neuropsychopharmacology, 36:235–243. https://doi.org/10.1016/j.euroneuro.2020.03.003
    1. Austad G, Joa I, Johannessen JO, Larsen TK (2015) Gender differences in suicidal behaviour in patients with first-episode psychosis. Early Interv Psychiatry 9(4):300–307. https://doi.org/10.1111/eip.12113 - DOI - PubMed

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