Sex and gender differences in psychopathology and neurocognition in emerging psychoses

There has been large evidence that patients with psychotic disorders, such as schizophrenia, usually experience early signs of psychosis even before developing frank psychosis. In recent years, research into the field of early detection, in particular the identification of factors that increase disease risk, has received growing scientific and clinical interest. An intriguing research area in this field is the investigation of gender differences. The present dissertation aims to investigate (1) gender differences in symptomatology, drug use, comorbidity (i.e. substance use, affective and anxiety disorders) and global functioning in patients with an at-risk mental state (ARMS) for psychosis, (2) sex differences in cognitive functioning in ARMS patients and healthy controls (HC), (3) gender differences in the first self-perceived signs and symptoms in ARMS and first-episode psychosis (FEP) patients.
The first study demonstrated that gender differences in symptomatology and comorbidity in ARMS patients are similar to those seen in overt psychosis and in healthy controls. However, the observed differences were so small that they are probably not clinically meaningful. The second study showed that sex differences in cognitive functioning in ARMS are similar to those seen in healthy men and women. In particular, the female advantage in verbal learning and memory seems to be equally present in ARMS patients and HC. Our third study found only few and relatively small gender differences in the first self-perceived signs and symptoms. While men initially mainly noticed negative and cognitive symptoms, women first noticed (sub-threshold) positive and affective symptoms.
All in all, regarding emerging symptomatology and cognitive functioning, it seems that the above described differences between women and men – if present at all – are small and resemble those in the general population. Similarly, few gender differences were found regarding first self-perceived signs and symptoms.