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The influence of gender on clinical and social characteristics of patients at psychosis onset: a report from the Psychosis Incident Cohort Outcome Study (PICOS)

Published online by Cambridge University Press:  14 October 2011

M. Bertani ,
A. Lasalvia ,
C. Bonetto ,
S. Tosato ,
D. Cristofalo ,
S. Bissoli ,
K. De Santi ,
R. Mazzoncini ,
L. Lazzarotto  and
M. Santi
...Show all authors
M. Bertani
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
A. Lasalvia*
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
C. Bonetto
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
S. Tosato
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
D. Cristofalo
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
S. Bissoli
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
K. De Santi
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
R. Mazzoncini
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
L. Lazzarotto
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
M. Santi
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
A. Sale
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
D. Scalabrin
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
M. Abate
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
M. Tansella
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
M. Ruggeri
Affiliation:
Department of Public Health and Community Medicine, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy
*
*Address for correspondence: A. Lasalvia, M.D., Ph.D., Section of Psychiatry and Clinical Psychology, Department of Public Health and Community Medicine, University of Verona, Ospedale Policlinico ‘GB. Rossi’, Piazzale L. A. Scuro 10, 37134 Verona, Italy. (Email: antonio.lasalvia@univr.it)
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Abstract

Background

This paper examined the hypothesis that males with first-episode psychosis (FEP) experience lower pre-morbid adjustment, greater social disability and more self-perceived needs at illness onset than females (by controlling for duration of untreated psychosis, diagnosis, age and symptoms at onset). Results disconfirming this hypothesis were thought to suggest the potentially mediating role of social context in determining the impact of symptoms and disability on the everyday lives of male patients in the early phase of psychosis.

Method

A large epidemiologically representative cohort of FEP patients (n=517) was assessed within the Psychosis Incident Cohort Outcome Study (PICOS) framework – a multi-site research project examining incident cases of psychosis in Italy's Veneto region.

Results

Despite poorer pre-morbid functioning and higher social disability at illness onset, males reported fewer unmet needs in the functioning domain than females did. An analysis of help provided by informal caregivers showed that males received more help from their families than females did. This finding led us to disconfirm the second part of the hypothesis and suggest that the impact of poorer social performance and unmet needs on everyday life observed in male patients might be hampered by higher tolerance and more support within the family context.

Conclusions

These findings shed new light on rarely investigated sociocultural and contextual factors that may account for the observed discrepancy between social disability and needs for care in FEP patients. They also point to a need for further research on gender differences, with the ultimate aim of delivering gender-sensitive effective mental health care.

Keywords

First-episode psychosisgender differencesneeds for carepre-morbid functioningsocial disability
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 4 , April 2012 , pp. 769 - 780
Copyright
Copyright © Cambridge University Press 2011

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