|
| | Study | Sample characteristics | Outcome measures | Key finding | Main conclusion |
|
| Epidemiology | Amminger et al., 2006 [16] | 86 individuals considered to be at UHR for schizophrenia | Transition to psychosis | The rate of conversion to nonaffective psychosis was not higher among males than females. Female gender was a significant predictor of conversion to affective psychosis at 2-year follow-up. |
Inconsistent results were found: some studies did not show gender differences and others indicated a greater risk for conversion to psychosis in men.
More studies analyzing gender differences regarding transition to psychosis are needed. |
| Nordentoft et al., 2006 [17] | 79 patients diagnosed with schizotypal disorder | Transition to psychosis | Males versus females had a fourfold risk [RR: 4.47, CI: 1.30–15.33] for conversion to schizophrenia at 1-year follow-up. |
| Lemos-Giráldez et al., 2009 [18] | 61 participants meeting criteria for UHR of psychosis | Transition to psychosis | The conversion rate to psychosis was 22.95% in the three-year follow-up period without gender statistical gender differences (22.5% men versus 23.8% women). |
| Goldstein et al., 2011 [19] | 159 parents with psychoses and 114 comparable, healthy control parents. 203 HR and 147 control offspring. | Transmission to psychosis | Risk of psychosis in offspring was a function of the sex of parent and offspring. The male : female ratio for affected offspring differed significantly between affected mothers and fathers. |
| Ziermans et al., 2011 [20] | 72 adolescents putatively at UHR for psychosis | Transition to psychosis | 15.6% of UHR adolescents converted to psychosis at 2-year follow-up, with a higher proportion of men (13.8%). |
| Walder et al., 2013 [21] | 276 CHR NAPLS participants | Transition to psychosis | CHR participants who converted to psychosis (70, 34%) at some point over a 2.5-year follow-up period did not significantly differ in gender distribution. |
|
| Clinical expression | Willhite et al., 2008 [22] | 68 UHR patients assessed at baseline, six and twelve months later | Symptoms | Males appeared to have more severe negative symptoms when data from all three time points were examined. | Differences by gender were modest or absent under many variables that were classified as typical of schizophrenia in the past.
More negative symptoms in men versus females are the most replicated result in some of the CHR population studies, as in studies of patients with a psychotic spectrum disorder. |
| Lemos-Giráldez et al., 2009 [18] | 61 participants meeting criteria for UHR of psychosis | Symptoms and recovery pattern | No gender differences in symptom or functioning levels at the three follow-up time points (at baseline, at 1-year and at 3-year follow-up) were found. Males experienced faster and longer deterioration when psychotic symptoms arise. |
| Corcoran et al., 2011 [23] | 56 young people at CHR for psychosis | Negative symptoms | As for gender, male patients only had significantly more negative symptoms than females. |
| Cocchi et al., 2014 [24] | 106 patients at UHR of psychosis | Age at onset and DUI | No gender differences were found in age of onset, DUI, symptom severity, or level of functioning. |
|
| Social functioning | Willhite et al., 2008 [22] | 68 UHR patients assessed at baseline, six and twelve months later. | Functioning and social support | Males were rated as having marginally lower functioning than females over the three follow-up time points. Males reported less positive social support than their female counterparts and felt they received marginally more criticism than females. |
Most studies indicated gender differences in premorbid and psychosocial functioning, being worse in men.
Social dysfunction in adolescence might be a good predictor of transition to psychosis. |
| Lemos-Giráldez et al., 2009 [18] | 61 participants meeting criteria for UHR of psychosis | Social functioning | No gender differences in functioning levels at the three follow-up time points (at baseline, at 1-year and at 3-year follow-up) were found. |
| Salokangas et al., 2013 [25] | 244 young help-seeking CHR patients | Psychosocial state | At baseline, males’ psychosocial situation was poorer than that of females, but at follow-up there was no longer any gender difference in psychosocial outcome. There was also no gender difference in global outcome. |
| Tarbox et al., 2013 [26] | 270 CHR individuals in the NAPLS | Premorbid functioning | In the full CHR sample, male participants had worse social functioning in early and late adolescence. Early adolescent social dysfunction significantly predicted conversion to psychosis. |
| Walder et al., 2013 [21] | 276 CHR NAPLS participants | Premorbid adjustment and social and role functioning | Baseline social and role functioning are more impaired in CHR males than females (though not in early childhood adjustment). |
|
| Cognitive functioning | Walder et al., 2008 [27] | 37 youth at HR for psychosis | Neurocognitive performance | AHRP+ females performed worse than same-gender AHRP− on several neurocognitive measures. There were no significant differences between male converters and nonconverters. AHRP− males performed worse than their HR female counterparts on a variety of neurocognitive measures. AHRP+ females performed worse than their HR male counterparts on a measure of verbal memory. | Neurocognitive performance in CHR shows a differential gender effect that varies by risk status.
It suggests the importance of considering sexually differentiated patterns of cognitive decline in prodromal subjects. |
|
