Sex Differences in Symptom Presentation in the Psychosis Prodrome Open Access

Holtzman, Carrie (2014)

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There are well-established sex differences in the presentation and course of schizophrenia that contribute to the heterogeneity of the disorder, but the extent to which these sex differences pre-exist the onset of psychosis is unclear. The present study examines sex differences in symptom presentation in individuals at high risk for psychosis (i.e. "prodromal") with two aims: to determine if sex differences in the prodrome mirror those seen in patients diagnosed with schizophrenia and to test whether different combinations of prodromal symptoms predict conversion to psychosis separately for males and females. The Structured Interview for Prodromal Symptoms (Miller et al., 2002) was used to assess 212 participants at baseline and a six-month follow-up, 47 of whom converted to psychosis within 24 months. Results indicated that prodromal males experienced more negative and disorganized symptoms, consistent with literature in patients diagnosed with schizophrenia. There were no sex differences in positive or mood symptoms. Prodromal symptoms predicted conversion differently for males and females. This study suggests that sex differences in symptoms presentation predate the onset of psychosis and that, accordingly, sex must be taken into account in generating accurate prediction models.

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Table 1: Demographic Characteristics..35

Table 2: Medication Status by Sex..36

Table 3: SIPS Symptom Ratings by Sex and Conversion Status..37

Table 4: Repeated Measures Analysis of Variance: Symptom Ratings by Sex and Conversion Status.39

Table 5: Repeated Measures Analysis of Variance : Individual Positive Symptoms by Sex and Conversion Status..42

Figure 1: Positive Symptom Severity by Sex and Conversion Status at Baseline and Follow-Up..45

Figure 2: Negative Symptom Severity by Sex and Conversion Status at Baseline and Follow-Up..46

Figure 3: Dysphoric Mood Severity by Sex and Conversion Status at Baseline and Follow-Up..47


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