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

• Published in: European psychiatry Vol. 67; no. S1; pp. S470 - S471
• Main Authors: Jiménez-Fernández, B, Toll-Privat, A, Bergé-Baquero, D, Motta-Rojas, N V, Delgado-Marí, M, Legido-Gil, T, Martínez-Sarduní, L, Cuevas-Esteban, J, Mané-Santacana, A
• Format: Journal Article
• Language: English
• Published: Paris Cambridge University Press 01.08.2024
• Subjects: Gender differences; Psychosis; Women
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1192/j.eurpsy.2024.975

IntroductionDiagnostic 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.ObjectivesTo determine the role of sex in diagnostic stability in a sample of FEP after 1-year follow-up.MethodsDiagnoses 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.Results256 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 participantsCompleters (n=188)Non-completers (n=68)pWomen (n, %)71 (37.8)30 (44.1)0.111Age (M, IQR)24 (20-28)22 (20-28)0.899Cannabis use (M, IQR)5.5 (0-18)7 (0-21)0.231DUP (M, IQR)45 (12.5-130)36 (11.25-115.75)0.213PANSS (m, sd)44.55 (10.17)40.93 (10.42)0.761CDSS (M, IQR)2 (0-7)3 (0-5.5)0.199YMRS (m, sd)19 (9.64)17.6 (9.15)0.845GAF (M, IQR)30 (25-50)30 (25-35)0.114TABLE 2A and 2B.Diagnosis comparison (n, %)Baseline1-year follow-upMenWomenTotalMenWomenTotalPsychosis 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-upMenWomenTotalMenWomenTotalAffective 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:ConclusionsSex has proven to be the main predictor of switching initial diagnosis of FEP.Disclosure of InterestNone Declared