Mazza Marianna, Caroppo Emanuele, De Berardis Domenico, Marano Giuseppe, Avallone Carla, Kotzalidis Georgios D, Janiri Delfina, Moccia Lorenzo, Simonetti Alessio, Conte Eliana, Martinotti Giovanni, Janiri Luigi, Sani Gabriele
Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Institute of Psychiatry and Psychology, Department of Geriatrics, Neuroscience and Orthopedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Pers Med. 2021 Dec 2;11(12):1279. doi: 10.3390/jpm11121279.
Early detection and prompt treatment of psychosis is of the utmost importance. The great variability in clinical onset, illness course, and response to pharmacological and psychosocial treatment is in great part gender-related. Our aim has been to review narratively the literature focusing on gender related differences in the psychoses, i.e., schizophrenia spectrum disorders. We searched the PubMed/Medline, Scopus, Embase, and ScienceDirect databases on 31 July 2021, focusing on recent research regarding sex differences in early psychosis. Although women, compared to men, tend to have better overall functioning at psychotic symptom onset, they often present with more mood symptoms, may undergo misdiagnosis and delay in treatment and are at a higher risk for antipsychotic drug-induced metabolic and endocrine-induced side effects. Furthermore, women with schizophrenia spectrum disorders have more than double the odds of having physical comorbidities than men. Tailored treatment plans delivered by healthcare services should consider gender differences in patients with a diagnosis of psychosis, with a particular attention to early phases of disease in the context of the staging model of psychosis onset.
精神病的早期发现和及时治疗至关重要。临床发病、病程以及对药物和心理社会治疗的反应存在很大差异，这在很大程度上与性别有关。我们的目的是对聚焦于精神病（即精神分裂症谱系障碍）中性别相关差异的文献进行叙述性综述。我们于2021年7月31日在PubMed/Medline、Scopus、Embase和ScienceDirect数据库中进行了检索，重点关注早期精神病中性别差异的最新研究。尽管与男性相比，女性在精神病症状发作时往往整体功能较好，但她们通常会出现更多情绪症状，可能会被误诊并延误治疗，且抗精神病药物诱发的代谢和内分泌副作用风险更高。此外，患有精神分裂症谱系障碍的女性出现躯体合并症的几率是男性的两倍多。医疗服务提供的定制化治疗方案应考虑精神病诊断患者的性别差异，尤其要关注精神病发作分期模型背景下疾病的早期阶段。
