Gender differences in first-episode psychosis at 5-year follow-up - two different courses of disease? Results from the OPUS study at 5-year follow-up
Gender differences in first-episode psychosis at 5-year follow-up - two different courses of disease? Results from the OPUS study at 5-year follow-up
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DOI：
10.1016/j.eurpsy.2012.11.005
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发表时间：
2014-01-01
影响因子：
7.8
通讯作者：
Nordentoft, M.
中科院分区：
文献类型：
--
作者：
Thorup, A.;Albert, N.;Nordentoft, M.
目的：精神病的性别差异已被研究，其结果有助于更好地了解该病，但许多问题仍未得到解答。在临床方面，女性和男性精神病患者在获得社会支持的机会、滥用药物的倾向、功能水平和症状模式方面存在差异。方法：共有578名首发精神分裂症患者被纳入丹麦OPUS试验，这是一项随机临床试验，比较了两年强化早期干预计划和标准治疗。所有患者在纳入时、2年和5年后用有效的仪器进行评估。对数据进行了显著的性别差异分析。结果：男性在任何时候都有明显更高的阴性症状水平，而且更有可能独居和遭受药物滥用。女性在后续行动中达到了更高的社会功能水平，并且比男性表现出更大的就业或受教育倾向。与孩子同住的女性明显多于男性。达到康复状态的女性多于男性，且对药物的依从性更强。结论：在这一庞大的首发精神病患者队列中，2年和5年的随访期存在显著的性别差异。男性和女性表现出不同的症状和不同的社会功能水平。(C)2012年爱思唯尔·马森公司。版权所有。
Objective: Gender differences in psychosis have been investigated, and the results have contributed to a better understanding of the disease, but many questions are unanswered. In clinical terms, women and men with psychosis differ in terms of access to social support, tendency of substance abuse, level of functioning and symptom patterns. We aimed to investigate how gender differences at onset of psychosis develop during the first 5 years of treatment.Method: A total of 578 patients with a first-episode psychosis in the schizophrenia spectrum were included in the Danish OPUS trial - a randomized clinical trial comparing 2 years of intensive early-intervention programme with standard treatment. All patients were assessed with validated instruments at inclusion, and after 2 and 5 years. Data were analysed for significant gender differences.Results: Males have significantly higher levels of negative symptoms at all times, and are more likely to live alone and suffer from substance abuse. Females reach higher levels of social functioning at follow-up, and show a greater tendency to be employed or in education than males. Markedly more women than men live with children. More women than men reach a state of recovery and are more compliant with medication.Conclusion: There are significant gender differences at 2- and 5-year follow-up in this large cohort of first-episode psychotic patients. Males and females show different symptomatology and different levels of social functioning. (C) 2012 Elsevier Masson SAS. All rights reserved.