Examining gender difference in adult-onset psychosis in Hong Kong

• Published in: Early intervention in psychiatry Vol. 10; no. 4; pp. 324 - 333
• Main Authors: Hui, Christy L.-M., Leung, Chung-Ming, Chang, Wing-Chung, Chan, Sherry K.-W., Lee, Edwin H.-M., Chen, Eric Y.-H.
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-08-2016; Wiley Subscription Services, Inc
• Subjects: Adult; Age of Onset; Asian Continental Ancestry Group - psychology; Cognition; Educational Status; Female; Gender; Humans; Independent Living - psychology; Intelligence; Male; Males; Middle Aged; Neuropsychological Tests; Prodromal Symptoms; Psychosis; Psychotic Disorders - diagnosis; Psychotic Disorders - drug therapy; Psychotic Disorders - psychology; Risk Factors; schizophrenia; Sex Characteristics; sex difference; Social Support; Work Performance; Hong Kong China; China; schizophrenia; cognition; sex difference; age of onset
• ISSN: 1751-7885; 1751-7893
• DOI: 10.1111/eip.12167

Aim
Gender‐specific treatment strategies for psychosis have been suggested in recent years. Data on gender difference were largely consistent regarding premorbid functioning, age of onset and negative symptoms; however, results regarding neurocognitive function and duration of untreated psychosis were mixed and inconclusive. In this study, we aimed at a thorough examination on the gender differences in 360 Chinese patients with first‐episode psychosis in Hong Kong.
Methods
From June 2009 to August 2011, participants were consecutively recruited from a population‐based territory‐wide study of early psychosis targeting first‐episode psychosis in Hong Kong. Comprehensive data on basic demographics, premorbid functioning and schizoid and schizotypal traits, clinical, functioning, medication side effects and a battery of neurocognitive measures were collected upon entry into the service.
Results
In 360 patients with first‐episode psychosis aged between 26 and 55 years, 43.6% (n = 157) were male and 56.4% (n = 203) were female. Males had poorer premorbid functioning and adjustment, earlier age of onset, more negative symptoms and poorer functioning in terms of work productivity, independent living and immediate social network relationships at presentation of first‐episode psychosis. Interestingly, our data indicate that males tend to be more educated, and also characterized by higher IQ, better neurocognitive performance on visual domain compared with females. Duration of untreated psychosis was not different between the two genders.
Conclusion
Data from this homogeneous cohort of Chinese populations enabled tailored and culturally sensitive recommendation on gender‐specific treatment strategies, hence improving patients' care and facilitate better diagnostic and interventional decisions for patients with psychosis.