Frontiers in Psychiatry (Oct 2022)

Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: differences between males and females

  • Maria Serra-Navarro,
  • Maria Serra-Navarro,
  • Silvia Amoretti,
  • Silvia Amoretti,
  • Silvia Amoretti,
  • Silvia Amoretti,
  • Norma Verdolini,
  • Norma Verdolini,
  • Norma Verdolini,
  • María Florencia Forte,
  • María Florencia Forte,
  • Ana M. Sánchez-Torres,
  • Ana M. Sánchez-Torres,
  • Eduard Vieta,
  • Eduard Vieta,
  • Derek Clougher,
  • Antonio Lobo,
  • Antonio Lobo,
  • Ana González-Pinto,
  • Ana González-Pinto,
  • Ana González-Pinto,
  • Rocío Panadero,
  • Rocío Panadero,
  • Alexandra Roldán,
  • Alexandra Roldán,
  • André F. Carvalho,
  • Elena de la Serna,
  • Elena de la Serna,
  • Alba Toll,
  • Alba Toll,
  • J. A. Ramos-Quiroga,
  • J. A. Ramos-Quiroga,
  • J. A. Ramos-Quiroga,
  • J. A. Ramos-Quiroga,
  • Carla Torrent,
  • Carla Torrent,
  • Manuel J. Cuesta,
  • Manuel J. Cuesta,
  • Miguel Bernardo,
  • Miguel Bernardo,
  • PEPs Group,
  • Jairo González-Díaz,
  • Lucila Barbosa,
  • Covadonga M. Diaz-Caneja,
  • Marta Rapado-Castro,
  • Carlo Alemany,
  • Aina Avila-Parcet,
  • Iñaki Zorrilla,
  • Itxasco Gonzalez-Ortega,
  • Concepción De-la-Cámara,
  • Pedro Saz,
  • Juan Nacher,
  • Esther Lorente,
  • Teresa Legido,
  • Francesc Casanovas,
  • Nestor Arbelo,
  • Lidia Ilzarbe,
  • Josefina Castro-Fornieles,
  • Immaculada Baeza,
  • Fernando Contreras,
  • Teresa Bobes Bascarán,
  • Leticia González-Blanco,
  • Rafael Segarra Echevarría,
  • Arantzazu Zabala Rabadán,
  • Roberto Rodriguez-Jimenez,
  • Luis Sanchez-Pastor,
  • Judith Usall,
  • Anna Butjosa,
  • Salvador Sarró,
  • María Ángeles García León,
  • Ángela Ibáñez,
  • Lucía Moreno-Izco,
  • Vicent Balanzá-Martinez

DOI
https://doi.org/10.3389/fpsyt.2022.982583
Journal volume & issue
Vol. 13

Abstract

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BackgroundDeficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset.Materials and methodsThe initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up.ResultsFEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = −0.307, p = 0.012) were significantly associated with functioning.ConclusionOur data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended.

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