Willhite Rachael K, Niendam Tara A, Bearden Carrie E, Zinberg Jamie, O'Brien Mary P, Cannon Tyrone D
University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, United States.
Schizophr Res. 2008 Sep;104(1-3):237-45. doi: 10.1016/j.schres.2008.05.019. Epub 2008 Jun 24.
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.
在首发和慢性精神分裂症患者的临床表现、心理社会功能及病程中,性别差异已被广泛观察到。然而,关于精神病前驱期的性别差异却知之甚少。本研究调查了处于发展为精神障碍超高风险的个体在症状、功能及社会支持方面的性别差异。68名超高风险患者在基线时接受了评估,其中27人在大约6个月和12个月后返回进行随访评估。通过临床访谈评估临床症状和功能;使用自我报告问卷测量社会支持。在人口统计学变量、基线时的症状或功能方面不存在性别差异。当综合考虑基线和随访时间点时,发现男性的阴性症状水平显著更高,功能水平略低。此外,女性在基线时报告的社会支持水平更高。发现阴性症状的差异介导了男性和女性患者在功能上的差异。本研究表明,症状表现和功能结局方面基于性别的差异可能在转化为精神病之前就已存在。后续研究应考察该人群中症状、功能和社会支持之间的关系。