Serra-Navarro Maria, Amoretti Silvia, Verdolini Norma, Forte María Florencia, Sánchez-Torres Ana M, Vieta Eduard, Clougher Derek, Lobo Antonio, González-Pinto Ana, Panadero Rocío, Roldán Alexandra, Carvalho André F, de la Serna Elena, Toll Alba, Ramos-Quiroga J A, Torrent Carla, Cuesta Manuel J, Bernardo Miguel
Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.
Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.
Front Psychiatry. 2022 Oct 20;13:982583. doi: 10.3389/fpsyt.2022.982583. eCollection 2022.
Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset.
The initial sample comprised 588 individuals. However, only adults with non-affective FEP ( = 247, 161 males and 86 females) and healthy controls ( = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up.
FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, = 0.003) and worse premorbid adjustment (β = 0.256, = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, = 0.003), executive function (β = 0.299, = 0.020) and CR (β = -0.307, = 0.012) were significantly associated with functioning.
Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended.
社会心理功能缺陷在精神病早期就已存在。若干因素，如病前适应、神经认知表现和认知储备（CR），可能影响功能。在多个领域的精神病患者中观察到了性别差异。然而，很少有研究探讨首发精神病（FEP）中按性别划分的功能不良预测因素。本研究旨在探讨性别差异，检查变化情况，并确定发病后按性别划分的功能预测因素。
初始样本包括588名个体。然而，仅纳入了非情感性FEP的成年人（n = 247，男性161名，女性86名）和健康对照者（n = 224，男性142名，女性82名）。在基线和2年随访时进行了包括功能、神经心理学和临床量表在内的综合评估。使用线性回归模型确定2年随访时功能的预测因素。
FEP患者在随访时功能得到改善（男性和女性均为67.4%）。在男性中，未治疗精神病的持续时间较长（β = 0.328，p = 0.003）和病前适应较差（β = 0.256，p = 0.023）与2年随访时的功能受损相关，而在女性中，处理速度（β = 0.403，p = 0.003）、执行功能（β = 0.299，p = 0.020）和CR（β = -0.307，p = 0.012）与功能显著相关。
我们的数据表明，FEP组2年随访时功能的预测因素因性别而异。因此，治疗和预防措施可能需要考虑性别因素进行调整。男性可能在早期阶段从功能康复中获益。相反，对于女性，可能建议以增强CR和认知康复为中心的早期干预。
