Gender differences in psychotic disorders with concurrent substance use.
OBJECTIVE
We conducted a comparative analysis of gender differences in patients with primary psychotic disorders with concurrent substance use and in those with substance-induced psychoses.


METHODS
A total of 385 individuals admitted to psychiatric emergency departments with early-onset psychosis and recent substance use were interviewed at baseline and at six-month intervals for two years. Using a standardized research diagnostic assessment instrument, we classified patients at baseline into primary and substance-induced psychosis groups and analyzed the effects of gender on demographic, family, and clinical characteristics at baseline, the interaction of gender and diagnosis, and gender main effects on illness course, adjustment, and service use over the two-year follow-up period.


RESULTS
Women had better premorbid adjustment, less misattribution of symptoms, and a later age at onset of regular drug use compared to men. Women, however, showed greater depression and histories of abuse compared to men. Men had greater arrest histories. No interactions between gender and diagnosis were significant. Both genders in the primary and substance-induced psychosis groups showed clinical and functional improvement over the follow-up period despite the overall minimal use of mental health and substance abuse treatment services.


CONCLUSIONS
Women and men with psychosis and substance use differ on several dimensions. Our findings suggest the need for gender-specific treatment programming across both diagnostic groups.
a Columbia University Department of Psychiatry and the New York State Psychiatric Institute , New York , New York , USA.
Carol L M
CL
Caton
Haiyi
H
Xie
Robert E
RE
Drake
Gregory
G
McHugo
D000328:Adult; D017668:Age of Onset; D015897:Comorbidity; D003863:Depression / Q000150:complications / Q000453:epidemiology; D017579:Domestic Violence; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D020127:Recovery of Function; D012727:Sex Characteristics; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy
gender differences; primary psychosis; substance-induced psychosis