Hoeksema Linda, Bruins Jojanneke, Timmerman Marieke E, Castelein Stynke
Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands; University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands.
Lentis Psychiatric Institute, Lentis Research, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands.
Schizophr Res. 2025 Mar;277:86-92. doi: 10.1016/j.schres.2025.01.029. Epub 2025 Mar 1.
Women generally have a later age of onset, and may therefore have a more favourable course of psychotic illness than men regarding psychopathology. Little is known about a broader range of outcomes, including well-being and recovery, and about the influence of age of onset. This study examines longitudinal sex-related and age of onset-related differences in well-being and recovery of people with a psychotic disorder with long illness durations.
Routine outcome monitoring data (2012-2021) of n = 3843 patients were used. Well-being (quality of life and personal recovery) and recovery (clinical and societal recovery and psychosocial functioning) were assessed. Latent class growth analysis (LCGA) was performed to assess whether classes with different trajectories of well-being and recovery could be identified. Classes were related to sex and (early/late) age of onset of psychosis (EOP/LOP).
LCGA identified five classes with varying combinations in levels of well-being and recovery, which were stable over time. Sex, age of onset and the combination of these two were significantly related to class membership. Women and individuals with LOP were more prevalent in better functioning classes than men and individuals with EOP.
This study showed sex differences in long-term recovery patterns of psychosis. Not only women but also individuals with LOP had a higher chance of better well-being and recovery, while men with EOP were at risk for worse outcomes. Taking these sex differences into account when deciding on policy and treatment protocols for individual patients might provide better mental health care to people with psychosis.
女性通常起病年龄较晚，因此在精神病理学方面，她们可能比男性有更有利的精神病病程。关于更广泛的结果，包括幸福感和康复情况，以及起病年龄的影响，人们所知甚少。本研究考察了患有长期精神疾病的精神病患者在幸福感和康复方面与性别及起病年龄相关的纵向差异。
使用了n = 3843名患者的常规结局监测数据（2012 - 2021年）。评估了幸福感（生活质量和个人康复）和康复情况（临床和社会康复以及心理社会功能）。进行了潜在类别增长分析（LCGA），以评估是否可以识别出具有不同幸福感和康复轨迹的类别。这些类别与性别以及精神病的（早/晚）起病年龄（EOP/LOP）相关。
LCGA识别出了五个在幸福感和康复水平上具有不同组合的类别，这些类别随时间保持稳定。性别、起病年龄以及这两者的组合与类别归属显著相关。与男性和早发性精神病患者相比，女性和晚发性精神病患者在功能较好的类别中更为普遍。
本研究显示了精神病长期康复模式中的性别差异。不仅女性，而且晚发性精神病患者有更高的机会获得更好的幸福感和康复，而早发性精神病男性患者有出现更差结局的风险。在为个体患者制定政策和治疗方案时考虑这些性别差异，可能会为精神病患者提供更好的精神卫生保健。
