title: Gender differences in first episode psychotic mania.
abstract: BACKGROUND
  The aim of this paper was to delineate the impact of gender on premorbid history, onset, and 18 month outcomes of first episode psychotic mania (FEPM) patients.
  
  
  METHODS
  Medical file audit assessment of 118 (male = 71; female = 47) patients with FEPM aged 15 to 29 years was undertaken on clinical and functional measures.
  
  
  RESULTS
  Males with FEPM had increased likelihood of substance use (OR = 13.41, p <.001) and forensic issues (OR = 4.71, p = .008), whereas females were more likely to have history of sexual abuse trauma (OR = 7.12, p = .001). At service entry, males were more likely to be using substances, especially cannabis (OR = 2.15, p = .047), had more severe illness (OR = 1.72, p = .037), and poorer functioning (OR = 0.96, p = .045). During treatment males were more likely to decrease substance use (OR = 5.34, p = .008) and were more likely to be living with family (OR = 4.30, p = .009). There were no gender differences in age of onset, psychopathology or functioning at discharge.
  
  
  CONCLUSIONS
  Clinically meaningful gender differences in FEPM were driven by risk factors possibly associated with poor outcome. For males, substance use might be associated with poorer clinical presentation and functioning. In females with FEPM, the impact of sexual trauma on illness course warrants further consideration.
authors.affiliation: Orygen Youth Health Research Centre, University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Victoria, 3052, Australia. smcotton@unimelb.edu.au
authors.forename: Sue M
authors.initials: SM
authors.lastname: Cotton
authors.forename: Martin
authors.initials: M
authors.lastname: Lambert
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.forename: Benno G
authors.initials: BG
authors.lastname: Schimmelmann
authors.forename: Felicity J
authors.initials: FJ
authors.lastname: Butselaar
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.forename: Philippe
authors.initials: P
authors.lastname: Conus
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D012742:Sex Offenses / Q000523:psychology; D019966:Substance-Related Disorders / Q000150:complications; D055815:Young Adult