scholarly journals Gender Differences in Individuals at High-Risk of Psychosis: A Comprehensive Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Ana Barajas ◽  
Susana Ochoa ◽  
Jordi E. Obiols ◽  
Lluís Lalucat-Jo
Keyword(s):  
Gender Differences ◽  
High Risk ◽  
Social Functioning ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Control Variable ◽  
Prodromal Phase ◽  
Men And Women ◽  
Conversion Rates ◽  
High Risk Populations

Introduction. To date, few studies have focused on the characterization of clinical phenomenology regarding gender in population at high-risk of psychosis. This paper is an attempt to summarize the findings found in the scientific literature regarding gender differences in high-risk populations, taking into account parameters studied in populations with schizophrenia and other psychotic disorders, such as incidence, clinical expression, duration of untreated illness (DUI), social functioning, and cognitive impairment prior to full-blown psychosis development.Method. Studies were systematically searched in PubMed. Studies using gender variable as a control variable were excluded. 12 studies met inclusion criteria.Results. Most of the studies found a differential pattern between women and men as regards clinical, social, and cognitive variables in the prodromal phase, with worse performance in men except in cognitive functioning (more severe negative symptoms, worse social functioning, and longer DUI in men). Similar conversion rates over time were found between men and women.Conclusions. Many of the studies analyzed suggest that differences between men and women in the expression of psychosis extend across a continuum, from the subclinical forms of illness to the debut of psychosis. However, the small number of studies and their significant methodological and clinical limitations do not allow for firm conclusions.

scholarly journals Vertebral Fractures in Ireland: A Sub-analysis of the DXA HIP Project

2021 ◽  
Author(s):  
John J Carey ◽  
Lan Yang ◽  
E. Erjiang ◽  
Tingyan Wang ◽  
Kelly Gorham ◽  
...  
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Vertebral Fractures ◽  
Fragility Fractures ◽  
Vertebral Fracture Assessment ◽  
International Studies ◽  
Men And Women ◽  
Women Subjects ◽  
The World ◽  
High Risk Populations

AbstractOsteoporosis is an important global health problem resulting in fragility fractures. The vertebrae are the commonest site of fracture resulting in extreme illness burden, and having the highest associated mortality. International studies show that vertebral fractures (VF) increase in prevalence with age, similarly in men and women, but differ across different regions of the world. Ireland has one of the highest rates of hip fracture in the world but data on vertebral fractures are limited. In this study we examined the prevalence of VF and associated major risk factors, using a sample of subjects who underwent vertebral fracture assessment (VFA) performed on 2 dual-energy X-ray absorptiometry (DXA) machines. A total of 1296 subjects aged 40 years and older had a valid VFA report and DXA information available, including 254 men and 1042 women. Subjects had a mean age of 70 years, 805 (62%) had prior fractures, mean spine T-score was − 1.4 and mean total hip T-scores was − 1.2, while mean FRAX scores were 15.4% and 4.8% for major osteoporotic fracture and hip fracture, respectively. Although 95 (7%) had a known VF prior to scanning, 283 (22%) patients had at least 1 VF on their scan: 161 had 1, 61 had 2, and 61 had 3 or more. The prevalence of VF increased with age from 11.5% in those aged 40–49 years to > 33% among those aged ≥ 80 years. Both men and women with VF had significantly lower BMD at each measured site, and significantly higher FRAX scores, P < 0.01. These data suggest VF are common in high risk populations, particularly older men and women with low BMD, previous fractures, and at high risk of fracture. Urgent attention is needed to examine effective ways to identify those at risk and to reduce the burden of VF.

Clinical high risk for psychosis: gender differences in symptoms and social functioning

2015 ◽  
Vol 11 (4) ◽  
pp. 306-313 ◽  
Author(s):  
Liz Rietschel ◽  
Martin Lambert ◽  
Anne Karow ◽  
Mathias Zink ◽  
Hendrik Müller ◽  
...  
Keyword(s):  
Gender Differences ◽  
High Risk ◽  
Social Functioning ◽  
Clinical High Risk

scholarly journals Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning – Results from the EU-GEI study

2019 ◽  
Vol 59 ◽  
pp. 52-59 ◽  
Author(s):  
Stephanie Menghini-Müller ◽  
Erich Studerus ◽  
Sarah Ittig ◽  
Ulrike Heitz ◽  
Laura Egloff ◽  
...  
Keyword(s):  
Gender Differences ◽  
At Risk ◽  
Drug Use ◽  
Anxiety Disorders ◽  
Statistical Power ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Cannabis Use ◽  
First Episode ◽  
Global Functioning

AbstractBackground:Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated gender differences in symptomatology, drug use, comorbidity (i.e. substance use, affective and anxiety disorders) and global functioning in patients with an at-risk mental state (ARMS) for psychosis.Methods:The sample consisted of 336 ARMS patients (159 women) from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews.Results:In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing.Conclusions:Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful.

scholarly journals Modeling the role of negative symptoms in determining social functioning in individuals at clinical high risk of psychosis

2015 ◽  
Vol 169 (1-3) ◽  
pp. 204-208 ◽  
Author(s):  
Danielle A. Schlosser ◽  
Timothy R. Campellone ◽  
Bruno Biagianti ◽  
Kevin L. Delucchi ◽  
David E. Gard ◽  
...  
Keyword(s):  
High Risk ◽  
Social Functioning ◽  
Negative Symptoms ◽  
Clinical High Risk

Clinical Profiles, Scope and General Findings of the Western Sydney First Episode Psychosis Project

2005 ◽  
Vol 39 (1-2) ◽  
pp. 36-43 ◽  
Author(s):  
Anthony Harris ◽  
John Brennan ◽  
Josephine Anderson ◽  
Anne Taylor ◽  
Mark Sanbrook ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Health Services ◽  
Social Functioning ◽  
Mood Disorders ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
The Other ◽  
First Episode ◽  
Schizophrenia Group

Objective: To examine the clinical profile, treatment and social functioning of a communitybased sample of young people presenting with their first episode of psychosis. Methods: Over a 2-year period, young people with their first episode of psychosis referred to early intervention services in two area mental health services in western Sydney were assessed with a battery of clinical, neuropsychological, psychophysiological and neuroanatomical measures. This paper reports the clinical results of the baseline section of the study. Results: Of the 224 referrals to the project, 94 subjects meet inclusion criteria and agreed to take part. Subjects were divided into three diagnostic groups – ‘Schizophrenia’, ‘Mood Disorders’ and ‘Mixed Psychosis’, the latter principally comprised of substance induced psychotic disorders. Subjects from the ‘Schizophrenia’ group differed significantly from the other two groups in that they had higher levels of negative symptoms and general psychopathology, and were less likely to be employed or engaged in study. They had poorer overall social functioning. Subjects with ‘Mixed Psychosis’ were similar to those from the ‘Schizophrenia’ group in that they were older and male, but they did not have the same burden of negative symptoms as the ‘Schizophrenia’ group. The ‘Mood Disorders’ group was younger, female and had overall a higher level of psychosocial functioning than the other two groups. Subjects from the ‘Mood Disorders’ group were more likely to be managed with mood stabilisers and multiple drug therapies. The use of atypical antipsychotic medication was almost universal. Conclusions: Even shortly after the time of presentation to mental health services young people with a schizophrenia spectrum diagnosis have a heavier burden of symptoms and are significantly more impaired by them than young people with other psychotic illnesses. This and their symptom profile differentiated them from young people with other psychotic disorders.

Gender differences in first-episode psychosis at 5-year follow-up – two different courses of disease? Results from the OPUS study at 5-year follow-up

2014 ◽  
Vol 29 (1) ◽  
pp. 44-51 ◽  
Author(s):  
A. Thorup ◽  
N. Albert ◽  
M. Bertelsen ◽  
L. Petersen ◽  
P. Jeppesen ◽  
...  
Keyword(s):  
Gender Differences ◽  
Substance Abuse ◽  
Social Functioning ◽  
Negative Symptoms ◽  
First Episode Psychosis ◽  
First Episode ◽  
Intervention Programme ◽  
Episode Psychosis ◽  
Symptom Patterns

AbstractObjectiveGender differences in psychosis have been investigated, and the results have contributed to a better understanding of the disease, but many questions are unanswered. In clinical terms, women and men with psychosis differ in terms of access to social support, tendency of substance abuse, level of functioning and symptom patterns. We aimed to investigate how gender differences at onset of psychosis develop during the first 5 years of treatment.MethodA total of 578 patients with a first-episode psychosis in the schizophrenia spectrum were included in the Danish OPUS trial – a randomized clinical trial comparing 2 years of intensive early-intervention programme with standard treatment. All patients were assessed with validated instruments at inclusion, and after 2 and 5 years. Data were analysed for significant gender differences.ResultsMales have significantly higher levels of negative symptoms at all times, and are more likely to live alone and suffer from substance abuse. Females reach higher levels of social functioning at follow-up, and show a greater tendency to be employed or in education than males. Markedly more women than men live with children. More women than men reach a state of recovery and are more compliant with medication.ConclusionThere are significant gender differences at 2- and 5-year follow-up in this large cohort of first-episode psychotic patients. Males and females show different symptomatology and different levels of social functioning.

Analysis of the duration of untreated illness (DUI) in the first episode psychosis Program (FEP) in AGS South Granada

2016 ◽  
Vol 33 (S1) ◽  
pp. S577-S578
Author(s):  
B. Girela Serrano ◽  
M. Guerrero Jiménez ◽  
C.M. Carrillo de Albornoz Calahorro ◽  
J.A. Rodrigo Manzano ◽  
O.B. Martínez García
Keyword(s):  
Social Functioning ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Average Score ◽  
First Episode ◽  
Toxic Substances ◽  
Relevant Variable ◽  
Duration Of Untreated Illness ◽  
Social Functioning Scale ◽  
Competing Interest

IntroductionDuration of untreated illness (DUI) has been considered as a relevant variable used to measure the degree of disabilities that are associated with psychotic disorders. In this paper we describe a cluster of patients with a DUI superior to 1 year according to their symptoms and sociofamiliar functioning.MethodsWe compare a group with a DUI superior to 1 year (n = 7) against a group with a DUI inferior to 1 year (n = 17).ResultsThe group with a DUI superior to 1 year showed an average age of 4 years younger (21) as the duration of untreated psychosis (DUP) of 1 to 3 months in the 80% of cases and higher percentage of unemployed or without occupation. The 60% were derived from primary care, compared to the 17% of the other group. Although the consumption of toxic substances was similar in both groups, no toxic psychosis were found in comparison with the 35% present in the group with a DUI inferior to 1 year. PANSS’ profile scored more positive and less negative symptoms. Both have similar general psychopathology. There were group differences in the Social Functioning Scale (SFS) with lower scores in the superior to 1 year DUI, in the following scales: Prosocial, Autonomy, Execution and Employment. The Global Assessment of Functioning (GAF) gives an average of almost 8 points higher.DiscussionWhile the SFS shows significant differences in several areas of social functioning, both PANSS’ profile and the family questionnaire do not support greater deterioration, as evidenced in the GAF's average score.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals S21. CORRELATES AND TRANSITION RATE OF CHILDREN AND ADOLESCENTS WITH ATTENUATED PSYCHOTIC SYMPTOMS: FINDINGS FROM A LONGITUDINAL STUDY

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S38-S38
Author(s):  
Silvia Molteni ◽  
Giulia Spada ◽  
Eleonora Filosi ◽  
Martina Maria Mensi ◽  
Elena Ballante ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Children And Adolescents ◽  
Social Functioning ◽  
Transition Rate ◽  
Negative Symptoms ◽  
Clinical Severity ◽  
Psychotic Symptoms ◽  
Structured Interviews ◽  
Wide Range

Abstract Background The identification of people at high risk of developing psychosis is one of the most promising strategies to improve outcomes. However, in children and adolescents research on the high risk state and attenuated psychotic symptoms is still in its infancy and the clinical validity of at risk criteria appears understudied in this population (Tor et al. 2018). Thus, in this longitudinal cohort study, we aimed to: (1) characterize the clinical profile of APS adolescents, adolescents suffering from early onset psychosis (EOP) and adolescents with psychiatric disorders other than APS and EOP (non-APS) and (2) to calculate the cumulative transition rate to psychosis at follow-ups and investigate predictors of conversion to psychosis. Methods Help-seeking adolescents (aged 12–18 years) consecutively admitted to Child and Adolescent Neuropsychiatric inpatient and outpatient units of the IRCCS Mondino Foundation (Pavia, Italy) were recruited. The Comprehensive Assessment of At-Risk Mental State (CAARMS) was used in order to evaluate the presence of attenuated or full-blown psychotic symptoms. The final sample consisted of 31 EOP, 110 APS and 102 non-APS adolescents. At baseline patients underwent an extensive clinical and, in a subset, also neuropsychological assessment using standardized semi-structured interviews and instruments. All APS patients recruited until March 2019 were followed up for a median period of 33 months (range 4–81 months) and baseline measures were repeated (every 12 months). Transition to psychosis was defined according to the CAARMS criteria. Results At baseline, APS status was associated with poor socio-occupational functioning, especially social functioning (p&lt;0.0001), as well as clinical severity (p&lt;0.0001) as assessed by clinicians. APS adolescents reported a higher level of suicidality compared to non-APS (p=0.0003). The APS group displayed a higher number of comorbid disorders compared to the EOP and non-APS (p&lt;0.0001) and was related to a wide range of disorders. APS and non-APS adolescents did not significantly differ in any of the neuropsychological test administered, although a worsening trend was observed between the two groups with lower scores in APS adolescents. The cumulative proportion of psychosis transition in the APS group was 13%, 17%, 24.2% and 26.8% at 1,2,3 and 4-year follow-ups, respectively. A high percentage of APS patients received at least one psychotropic medication (62.1%) during the follow-up period, especially antipsychotics (43.7%). Baseline lower global and social functioning (p=0.0092), higher clinical severity (p&lt;0.0001), negative symptoms, lower Total IQ (p=0.02) and Processing Speed Index (p=0.03) were associated with transitioning to psychosis at follow-ups. Discussion Our findings support the validity and clinical relevance of the identification of APS in children and adolescents. Indeed, in our sample APS adolescents suffer from a variety of comorbidities and non-psychotic symptoms, present higher suicidality and are markedly impaired compared to non-psychotic adolescents not fulfilling APS criteria. Moreover, they show a cumulative transition risk to psychosis of 26.8% at 4 years that, although being lower than that found in adult samples, is still comparable to that of other conditions in preventive medicine.

scholarly journals Real-world effectiveness of antipsychotic treatment in psychosis prevention in a 3-year cohort of 517 individuals at clinical high risk from the SHARP (ShangHai At Risk for Psychosis)

2020 ◽  
Vol 54 (7) ◽  
pp. 696-706 ◽  
Author(s):  
TianHong Zhang ◽  
LiHua Xu ◽  
XiaoChen Tang ◽  
YanYan Wei ◽  
Qiang Hu ◽  
...  
Keyword(s):  
High Risk ◽  
Real World ◽  
Negative Symptoms ◽  
Low Dose ◽  
Antipsychotic Treatment ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Small Subgroup ◽  
Conversion Rates

Objective: Antipsychotics are widely used for treating psychosis, but it is unclear whether they can also prevent psychosis. This study attempted a longitudinal evaluation of antipsychotics under real-world conditions in China to evaluate their effect on the rate of conversion to psychosis in individuals with a clinical high risk (CHR) of psychosis. Method: A total of 517 CHR individuals were recruited between 2011 and 2016 and followed up for 3 years. Among these, 450 (87.0%) individuals completed follow-up, 108 (24.0%) showed conversion to psychosis and 309 (68.7%) received antipsychotics. The main outcome was conversion to psychosis. The sample was further stratified according to the severity of positive symptoms. Results: Patients who did not receive antipsychotics showed a lower conversion rate than those who did (17.7% vs 26.9%; odds ratio [OR] = 0.660, 95% confidence interval [CI] = [0.442, 0.985], p = 0.035). In mild CHR cases, antipsychotic treatment was more likely to be associated with conversion to psychosis, compared with the no-antipsychotics group, with no such difference observed in severe CHR cases. Among those who received antipsychotics, monotherapy or low-dose treatment was associated with lower conversion rates. Our results did not favor any specific type of antipsychotics and suggested that a very small subgroup of CHR individuals with severe positive and general symptoms but mild negative symptoms may benefit from antipsychotic treatment. Conclusions: Administration of antipsychotics to CHR patients is potentially harmful with no preventive benefits. We do not recommend antipsychotic treatment for CHR individuals, which is practiced widely in China, and strongly advise caution if these drugs are used.

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