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Sex differences in diagnostic stability in first episode psychosis after 1-year follow-up

Published online by Cambridge University Press:  27 August 2024

B. Jiménez-Fernández*
Affiliation:
1Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona
A. Toll-Privat
Affiliation:
1Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona 2Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid
D. Bergé-Baquero
Affiliation:
2Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid 3Institut de Neuropsiquiatria i Addiccions (INAD), Parc Salut Mar 4Fundació Hospital del Mar Medical Research Institute (IMIM)
N. V. Motta-Rojas
Affiliation:
1Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona
M. Delgado-Marí
Affiliation:
1Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona
T. Legido-Gil
Affiliation:
2Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid 3Institut de Neuropsiquiatria i Addiccions (INAD), Parc Salut Mar 4Fundació Hospital del Mar Medical Research Institute (IMIM)
L. Martínez-Sarduní
Affiliation:
3Institut de Neuropsiquiatria i Addiccions (INAD), Parc Salut Mar 4Fundació Hospital del Mar Medical Research Institute (IMIM)
T. Legido-Gil
Affiliation:
3Institut de Neuropsiquiatria i Addiccions (INAD), Parc Salut Mar 4Fundació Hospital del Mar Medical Research Institute (IMIM)
J. Cuevas-Esteban
Affiliation:
1Psychiatry, Hospital Universitari Germans Trias i Pujol, Badalona
A. Mané-Santacana
Affiliation:
3Institut de Neuropsiquiatria i Addiccions (INAD), Parc Salut Mar 4Fundació Hospital del Mar Medical Research Institute (IMIM) 5Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Diagnostic stability is a controversial issue in first episode psychosis (FEP) due to heterogenous symptoms and unclear affective symptoms. Differencing affective and non-affective psychoses is important as treatment strategies are different. Initial affective symptomatology has low specificity for predicting the subsequent diagnosis of affective psychosis. Sex has proven to be relevant for clinical and functional outcomes but it remains unclear how sex may contribute to diagnosis switch of FEP.

Objectives

To determine the role of sex in diagnostic stability in a sample of FEP after 1-year follow-up.

Methods

Diagnoses of FEP patients from Hospital del Mar of Barcelona were assessed at baseline and 1 year after. Univariate analyses was perfomed for all diagnoses and dichotomic variable (affective/non-affective). Logistic regression model was perfomed to know which variables predict diagnosis switch.

Results

256 patients were enrolled. No differences were found at baseline between completers and non-completers (Table 1). No significant differences between men and women at baseline diagnosis were found, neither all diagnoses (p=0.274) nor the dichotomic variable affective/non-affective (p=0.829) (Table 2AB). Significant differences were found at 1-year follow-up between men and women, for all diagnoses (p=0.043) and the dichotomic variable (p=0.039). Sex was the only variable that predicted diagnosis switch (Figure 1), PANSS, CDSS, YMRS, GAF and cannabis did not.Table 1.

Baseline characteristics of participants

Completers (n=188)Non-completers (n=68)p
Women (n, %)71 (37.8)30 (44.1)0.111
Age (M, IQR)24 (20-28)22 (20-28)0.899
Cannabis use (M, IQR)5.5 (0-18)7 (0-21)0.231
DUP (M, IQR)45 (12.5-130)36 (11.25-115.75)0.213
PANSS (m, sd)44.55 (10.17)40.93 (10.42)0.761
CDSS (M, IQR)2 (0-7)3 (0-5.5)0.199
YMRS (m, sd)19 (9.64)17.6 (9.15)0.845
GAF (M, IQR)30 (25-50)30 (25-35)0.114
TABLE 2A and 2B.

Diagnosis comparison (n, %)

Baseline1-year follow-up
MenWomenTotalMenWomenTotal
Psychosis NOS69 (59)39 (54.9)108 (57.4)28 (23.9)10 (14.1)38 (20.2)
Schizophreniform disorder22 (18.8)16 (22.5)38 (20.2)14 (129 (12.7)23 (12.2)
Induced psychosis4 (3.4)0 (0)4 (2.1)15 (12.8)4 (5.6)19 (10.1)
Affective psychosis17 (14.5)9 (12.7)26 (13.8)24 (20.5)25 (35.2)49 (26.1)
Schizophrenia0 (0)0 (0)1 (0.4)30 (25.6)14 (19.7)44 (23.4)
Brief psychotic disorder5 (4.3)7 (9.9)12 (6.4)6 (5.1)8 (11.3)14 (7.4)
Baseline1-year follow-up
MenWomenTotalMenWomenTotal
Affective psychosis17 (14.5)9 (12.7)26 (13.8)24 (20.5)25 (35.2)49 (26.1)
Non-affective psychosis100 (85.5)62 (87.3)162 (86.2)93 (79.5)46 (64.8)139 (73.9)

Image:

Conclusions

Sex has proven to be the main predictor of switching initial diagnosis of FEP.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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