Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning – Results from the EU-GEI study

EU-GEI High Risk Study Group

doi:10.1016/j.eurpsy.2019.04.007

Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning – Results from the EU-GEI study

EU-GEI High Risk Study Group

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Abstract

Background: Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated 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. Methods: The sample consisted of 336 ARMS patients (159 women)from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews. Results: In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing. Conclusions: Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful.

Original language	English
Pages (from-to)	52-59
Number of pages	8
Journal	European Psychiatry
Volume	59
Early online date	7 May 2019
DOIs	https://doi.org/10.1016/j.eurpsy.2019.04.007
Publication status	Published - Jun 2019

Funding

This work was supported by the European Union (European Community’s Seventh Framework Program [grant number HEALTH-F2-2010-241909 ; Project EU-GEI]). M.J.K. was supported by a Medical Research Council Fellowship [grant number MR/J008915/1 ]. EU-GEI High Risk Study Group – Author List Philip McGuire 2 , Lucia R. Valmaggia 3 , Matthew J. Kempton 2 , Maria Calem 2 , Stefania Tognin 2 , Gemma Modinos 2 , Lieuwe de Haan 4,7 , Mark van der Gaag 8,10 , Eva Velthorst 5,11 , Tamar C. Kraan 6 , Daniella S. van Dam 4 , Nadine Burger 7 , Barnaby Nelson 12,13 , Patrick McGorry 12,13 , G Paul Amminger 12,13 , Christos Pantelis 14 , Athena Politis 12,13 , Joanne Goodall 12,13 , Anita Riecher-Rössler 1 , Stefan Borgwardt 1 , Charlotte Rapp 1 , Sarah Ittig 1 , Erich Studerus 1 , Renata Smieskova 1 , Rodrigo Bressan 15 , Ary Gadelha 15 , Elisa Brietzke 16 , Graccielle Asevedo 15 , Elson Asevedo 15 , Andre Zugman 15 , Neus Barrantes-Vidal 17 , Tecelli Domínguez-Martínez 18 , Anna Racioppi 19 , Paula Cristóbal-Narváez 19 , Thomas R. Kwapil 20 , Manel Monsonet 19 , Mathilde Kazes 21 , Claire Daban 21 , Julie Bourgin 21 , Olivier Gay 21 , Célia Mam-Lam-Fook 21 , Marie-Odile Krebs 21 , Dorte Nordholm 22 , Lasse Randers 22 , Kristine Krakauer 22 , Louise Glenthøj 22 , Birte Glenthøj 23 , Merete Nordentoft 22 , Stephan Ruhrmann 24 , Dominika Gebhard 24 , Julia Arnhold 25 , Joachim Klosterkötter 24 , Gabriele Sachs 26 , Iris Lasser 26 , Bernadette Winklbaur 26 , Philippe A. Delespaul 27,28 , Bart P. Rutten 29 , and Jim van Os 29,30 Affiliations 1 University Psychiatric Hospital, Wilhelm Klein-Strasse 27, CH-4002 Basel, Switzerland; 2 Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark 458 Hill, London, United Kingdom SE5 8AF; 3 Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, 456 London, United Kingdom SE5 8AF; 4 Amsterdam UMC, University of Amsterdam, Psychiatry, Department Early Psychosis, Meibergdreef 9, Amsterdam, The Netherlands; 5 Department of Psychiatry and Seaver Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, NY, US; 6 Mental Health Institute Arkin, Amsterdam, the Netherlands; 7 Arkin Amsterdam; 8 VU University, Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and Amsterdam Public Mental Health research institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; 9 Mental Health Institute Noord-Holland Noord, Hoorn, the Netherlands; 10 Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands; 11 Early Psychosis Section, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands; 12 Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne; 13 Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, Australia; 14 Melbourne Neuropsychiatry Centre, The University of Melbourne; 15 LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP; 16 Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP; 17 Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM); 18 CONACYT-Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (México); 19 Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona); 20 Department of Psychology, University of Illinois at Urbana-Champaign (USA); 21 University Paris Descartes, Hôpital Sainte-Anne, C’JAAD, Service Hospitalo-Universitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557) Paris, France; 22 Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen; 23 Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark; 24 Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany; 25 Psyberlin, Berlin, Germany; 26 Medical University of Vienna, Department of Psychiatry and Psychotherapy; 27 Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD 464 Maastricht, The Netherlands; 28 Mondriaan Mental Health Trust, P.O. Box 4436 CX Heerlen, The Netherlands; 29 Medical University of Vienna, Department of Psychiatry and Psychotherapy; 30 Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark 458 Hill, London, United Kingdom SE5 8AF.

Funders	Funder number
European Community’s Seventh Framework Program	HEALTH-F2-2010-241909
Medical Research Council	MR/J008915/1
European Commission

Keywords

Comorbidity
Functioning
Gender differences
Risk for psychosis
Sex differences

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.eurpsy.2019.04.007

gender-differences-of-patients-at-risk-for-psychosis-regarding-symptomatology-drug-use-comorbidity-and-functioning-results-from-the-eu-gei-studyFinal published version, 474 KBLicence: Article 25fa Dutch Copyright Act

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@article{f32e2dd905704ddab460c5d8ce8c5089,

title = "Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning – Results from the EU-GEI study",

abstract = "Background: Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated 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. Methods: The sample consisted of 336 ARMS patients (159 women)from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews. Results: In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing. Conclusions: Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful.",

keywords = "Comorbidity, Functioning, Gender differences, Risk for psychosis, Sex differences",

author = "Stephanie Menghini-M{\"u}ller and Erich Studerus and Sarah Ittig and Ulrike Heitz and Laura Egloff and Christina Andreou and Valmaggia, {Lucia R.} and Kempton, {Matthew J.} and {van der Gaag}, Mark and {de Haan}, Lieuwe and Barnaby Nelson and Neus Barrantes-Vidal and Merete Nordentoft and Stephan Ruhrmann and Gabriele Sachs and Rutten, {Bart P.} and Os, {Jim van} and Anita Riecher-R{\"o}ssler and {EU-GEI High Risk Study Group}",

year = "2019",

month = jun,

doi = "10.1016/j.eurpsy.2019.04.007",

language = "English",

volume = "59",

pages = "52--59",

journal = "European Psychiatry",

issn = "0924-9338",

publisher = "Elsevier Masson",

}

TY - JOUR

T1 - Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning – Results from the EU-GEI study

AU - Menghini-Müller, Stephanie

AU - Studerus, Erich

AU - Ittig, Sarah

AU - Heitz, Ulrike

AU - Egloff, Laura

AU - Andreou, Christina

AU - Valmaggia, Lucia R.

AU - Kempton, Matthew J.

AU - van der Gaag, Mark

AU - de Haan, Lieuwe

AU - Nelson, Barnaby

AU - Barrantes-Vidal, Neus

AU - Nordentoft, Merete

AU - Ruhrmann, Stephan

AU - Sachs, Gabriele

AU - Rutten, Bart P.

AU - Os, Jim van

AU - Riecher-Rössler, Anita

AU - EU-GEI High Risk Study Group

PY - 2019/6

Y1 - 2019/6

N2 - Background: Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated 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. Methods: The sample consisted of 336 ARMS patients (159 women)from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews. Results: In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing. Conclusions: Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful.

AB - Background: Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated 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. Methods: The sample consisted of 336 ARMS patients (159 women)from the prodromal work package of the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI; 11 centers). Clinical symptoms, drug use, comorbidity and functioning were assessed at first presentation to an early detection center using structured interviews. Results: In unadjusted analyses, men were found to have significantly higher rates of negative symptoms and current cannabis use while women showed higher rates of general psychopathology and more often displayed comorbid affective and anxiety disorders. No gender differences were found for global functioning. The results generally did not change when corrected for possible cofounders (e.g. cannabis use). However, most differences did not withstand correction for multiple testing. Conclusions: Findings indicate that gender differences in symptomatology and comorbidity in ARMS are similar to those seen in overt psychosis and in healthy controls. However, observed differences are small and would only be reliably detected in studies with high statistical power. Moreover, such small effects would likely not be clinically meaningful.

KW - Comorbidity

KW - Functioning

KW - Gender differences

KW - Risk for psychosis

KW - Sex differences

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U2 - 10.1016/j.eurpsy.2019.04.007

DO - 10.1016/j.eurpsy.2019.04.007

M3 - Article

AN - SCOPUS:85065137693

SN - 0924-9338

VL - 59

SP - 52

EP - 59

JO - European Psychiatry

JF - European Psychiatry

ER -

Gender differences of patients at-risk for psychosis regarding symptomatology, drug use, comorbidity and functioning – Results from the EU-GEI study

Abstract

Funding

Keywords

UN SDGs

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