Department of Psychiatry, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.
Early Interv Psychiatry. 2022 Jan;16(1):61-68. doi: 10.1111/eip.13131. Epub 2021 Feb 16.
Sex differences are well documented in schizophrenia, but have been much less studied in at-risk mental state (ARMS) for psychosis. We aimed to examine sex differences in symptomatology, cognition, social and role functioning in individuals with ARMS, with specific focus on clarifying relationships between sex, negative symptoms and functioning.
One hundred and seventy-seven Chinese participants aged 15-40 years with ARMS were recruited from a specialized early intervention service in Hong Kong. ARMS status was verified by Comprehensive Assessment of At-Risk Mental State. Assessments encompassing symptom profiles, a brief battery of cognitive tests and social and role functioning were conducted. Brief Negative Symptom Scale was adapted to measure negative symptoms at the level of five core domains.
Males with ARMS exhibited significantly poorer social functioning and more severe asociality of negative symptoms than female counterparts. Mediation analysis revealed that sex difference in social functioning became statistically insignificant when asocality was included in the model, indicating that asociality mediated the relationship between sex and social functioning. No sex differences were observed in other core domains of negative symptoms, other symptom dimensions, cognitive measures and role functioning.
This study suggests that sex differences in ARMS may be less pronounced that those observed in established psychotic disorders. Our findings of differential pattern of asociality between sexes and its mediating role on sex difference in social functioning underscore the importance in investigating negative symptoms at a separable domain-level. Further research is required to identify sex-specific predictors of longitudinal outcomes in at-risk populations.
精神分裂症中性别差异已有大量记载，但在精神病高危状态（ARMS）中研究较少。我们旨在研究处于 ARMS 状态的个体在症状学、认知、社会和角色功能方面的性别差异，并特别关注阐明性别、阴性症状和功能之间的关系。
从香港专门的早期干预服务中招募了 177 名年龄在 15-40 岁的有 ARMS 的中国参与者。ARMS 状态通过全面的高危精神状态评估来验证。评估包括症状谱、简短的认知测试组合以及社会和角色功能。简短的阴性症状量表被改编用于测量五个核心领域的阴性症状。
与女性相比，患有 ARMS 的男性表现出明显较差的社会功能和更严重的阴性症状的非社会性。中介分析表明，当将非社会性纳入模型时，社会功能的性别差异在统计学上变得不显著，表明非社会性中介了性别和社会功能之间的关系。在其他阴性症状的核心领域、其他症状维度、认知测量和角色功能方面，没有观察到性别差异。
这项研究表明，ARMS 中的性别差异可能不如在已确立的精神病障碍中那么明显。我们发现男女之间非社会性的差异模式及其在社会功能性别差异中的中介作用，强调了在可分离的领域层面研究阴性症状的重要性。需要进一步的研究来确定高危人群中特定于性别的纵向结局的预测因素。
