Gender differences in patients presenting with first-episode psychosis in Hong Kong: a three-year follow up study.
OBJECTIVE
The aim of the current study was to investigate gender differences with respect to pre-treatment characteristics, clinical presentation, service utilization and functional outcome in patients presenting with first-episode psychosis.


METHODS
A total of 700 participants (men, n = 360; women, n = 340) aged 15 to 25 years consecutively enrolled in a territory-wide first-episode psychosis treatment programme in Hong Kong from July 2001 to August 2003 were studied. Baseline and three-year follow up variables were collected via systematic medical file review.


RESULTS
At service entry, men had significantly lower educational attainment (p < 0.01), longer median duration of untreated psychosis (p < 0.001), fewer past suicidal attempts (p < 0.01), more severe negative symptoms (p < 0.05) and fewer affective symptoms (p < 0.01) than women. There was no significant gender difference in age of onset. In three-year follow up, men had more prominent negative symptoms (p < 0.001), fewer affective symptoms (p < 0.01), more violent behaviour and forensic records (p < 0.01), and higher rate of substance abuse (p < 0.01). Women achieved higher levels of functioning than men (Social Occupational Functioning Assessment Scale (SOFAS), p < 0.001) and a significantly higher proportion of women than men engaged in full-time employment or study for at least 12 consecutive months (p < 0.001) in the initial three years after psychiatric treatment.


CONCLUSIONS
Notable gender differences in clinical profiles, illness trajectory and functional outcome were demonstrated in Chinese young people suffering from first-episode psychosis. Differential needs between men and women and hence gender-specific therapeutic strategies should be considered in early intervention service.
Department of Psychiatry, Tai Po Hospital, Hong Kong. littlestone_113@yahoo.com
Wing Chung
WC
Chang
Jennifer Y M
JY
Tang
Christy L M
CL
Hui
Cindy P Y
CP
Chiu
May M L
MM
Lam
Gloria H Y
GH
Wong
Dicky W S
DW
Chung
C W
CW
Law
Steve
S
Tso
Kathy P M
KP
Chan
S F
SF
Hung
Eric Y H
EY
Chen
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012727:Sex Characteristics; D013406:Suicide, Attempted / Q000523:psychology