Gender differences in premorbid, entry, treatment, and outcome characteristics in a treated epidemiological sample of 661 patients with first episode psychosis

Cotton, Sue; Lambert, Michelle; Schimmelmann, Benno G.; Foley, Debra L.; Morley, Katherine I.; McGorry, Patrick D.; Conus, Philippe

doi:10.1016/j.schres.2009.07.002

Cited by 172 publications

(140 citation statements)

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“…Studies investigating the interaction between insight and the process of remission from early psychosis over time assessed patients either retrospectively (Cotton et al 2009) or prospectively over a relatively short time-frame (Mintz et al 2004; Parellada et al 2009; Buchy et al 2010; Capdevielle et al 2013; O'Connor et al 2013). Few studies followed patients up to 3 or 4 years either retrospectively (Gómez-de-Regil et al 2010) or prospectively (Crumlish et al 2005; Saeedi et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Insight as a social identity process in the evolution of psychosocial functioning in the early phase of psychosis

et al. 2016

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BackgroundAwareness of illness (insight) has been found to have contradictory effects for different functional outcomes after the early course of psychosis. Whereas it is related to psychotic symptom reduction and medication adherence, it is also associated with increased depressive symptoms. In this line, the specific effects of insight on the evolution of functioning over time have not been identified, and social indicators, such as socio-occupational functioning have barely been considered. Drawing from social identity theory we investigated the impact of insight on the development of psychosocial outcomes and the interactions of these variables over time.MethodThe participants, 240 patients in early phase of psychosis from the Treatment and Early Intervention in Psychosis Program (TIPP) of the University Hospital of Lausanne, Switzerland, were assessed at eight time points over 3 years. Cross-lagged panel analyses and multilevel analyses were conducted on socio-occupational and general functioning [Social and Occupational Functioning Assessment Scale (SOFAS) and Global Assessment of Functioning (GAF)] with insight, time and depressive symptoms as independent variables.ResultsResults from multilevel analyses point to an overall positive impact of insight on psychosocial functioning, which increases over time. Yet the cross-lagged panel analysis did not reveal a systematic positive and causal effect of insight on SOFAS and GAF scores. Depressive symptoms seem only to be relevant in the beginning of the treatment process.ConclusionsOur results point to a complex process in which the positive impact of insight on psychosocial functioning increases over time, even when considering depressive symptoms. Future studies and treatment approaches should consider the procedural aspect of insight.

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Section: Introductionmentioning

confidence: 99%

Insight as a social identity process in the evolution of psychosocial functioning in the early phase of psychosis

et al. 2016

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“…In order to develop better and more specific treatments researchers and clinicians focus on identifying factors associated with long-term disability that can be assessed already at the initial treatment contact (Kirkpatrick et al, 2006). Studies of patients coming into treatment for their first episode of psychosis show that severity of psychotic symptoms at first treatment contact as well as diagnosis has a relatively weak association with poor psychosocial functioning (from now called “functioning”) and is a poor predictor of future disability, while negative symptoms (Pogue-Geile and Harrow, 1985; White et al, 2009), male gender (Cotton et al, 2009), poor premorbid adjustment (Gonzalez-Ortega et al, 2013; MacBeth and Gumley, 2008; White et al, 2009), long duration of untreated psychosis (DUP) (Marshall et al, 2005; White et al, 2009), and cognitive dysfunction (Carlsson et al, 2006; Gonzalez-Blanch et al, 2010; Malla et al, 2002b) have been identified as stronger predictors.…”

Section: Introductionmentioning

confidence: 99%

Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis

Færden¹,

Barrett²,

Nesvåg³

et al. 2013

Psychiatry Research

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Background Apathy is a negative symptom associated with poor psychosocial functioning in schizophrenia but has not been sufficiently studied as predictor of poor functioning in first episode psychosis (FEP). Objective The main aim of the current study was to evaluate if apathy predicts poor functioning after 1 year in FEP patients in the context of other clinical variables with influence on outcome. Method Sixty-four FEP patients completed an extensive clinical and neuro-psychological test battery at baseline and 1-year follow-up. Symptoms were assessed with the Positive and Negative Syndrome scale (PANSS), apathy with the shortened Apathy Evaluation Scale (AES-C-12) and psychosocial functioning with the functioning score from the split version of the Global Assessment of Functioning scale (GAF-F). Results High levels of apathy, poor verbal memory and being male were the baseline variables that best predicted poor functioning at 1-year follow-up, explaining 34% of the variance in GAF-F. When PANSS negative factor was included in the analysis, the significance of AES-C-12 diminished. Conclusion These findings points to a robust role for apathy among the negative symptoms in the development of persisting psychosocial dysfunction in FEP and supports the current effort in targeting motivation to improve functioning.

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“…Men are usually more frequently single, with younger age at onset of psychiatric symptoms, with higher rates of illicit drug and alcohol use as well as cigarette smoking, and greater number of sexual partners 1,9,10,11 . In addition, men tend to have higher rates of hospitalization, more severe (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, men tend to have higher rates of hospitalization, more severe (e.g. psychoses) and substance use related diagnoses, while women tend to have higher rates of anxiety and depression 11,12,13,14,15 . It is not clear though whether differences in the rates of unprotected sex among men and women may be explained by clinical or contextual factors among people with mental illness under care.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with unprotected sexual practice among men and women with mental illnesses in Brazil

2014

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Gender differences in premorbid, entry, treatment, and outcome characteristics in a treated epidemiological sample of 661 patients with first episode psychosis

Cited by 172 publications

References 39 publications

Insight as a social identity process in the evolution of psychosocial functioning in the early phase of psychosis

Insight as a social identity process in the evolution of psychosocial functioning in the early phase of psychosis

Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis

Factors associated with unprotected sexual practice among men and women with mental illnesses in Brazil

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