title: Clinical high risk for psychosis: gender differences in symptoms and social functioning.
abstract: Schizophrenia is a heterogeneous disorder that presents differently in men and women: men show a higher propensity to negative symptoms, lower social functioning, earlier age at onset and co-morbid substance abuse, whereas women display more affective symptoms. It is unknown whether these differences extend to subjects at high risk (HR) of psychosis. Thus, the aim of the present study was to address this question.
  
  
  
  Clinical symptoms and functioning were assessed using structured interviews in 239 HR subjects (female, n = 80). The definition of being at HR was based on the criteria used in the European Prediction of Psychosis Study (EPOS).
  
  
  
  Men displayed more pronounced negative symptoms, higher rates of past substance abuse disorders and higher deficits in social functioning. No gender difference was found for depression, which affected almost 50% of the cohort, or age at onset for the fulfilment of HR criteria.
  
  
  
  The higher impairment in specific symptoms observed in male schizophrenia patients was also present in subjects at HR for psychosis. Further studies are required to determine whether these symptoms are gender-specific predictors of transition to psychosis and whether they warrant gender-specific interventions. The high propensity to depression in the present cohort, which was particularly pronounced in the male cohort compared with the general population, in conjunction with the observed increase in negative symptoms and functional impairment, should alert clinicians to the necessity for the identification and treatment of HR subjects, irrespective of the degree to which these features are associated with transition risk.
authors: Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.|Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors: Liz
authors: L
authors: Rietschel
authors: Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Martin
authors: M
authors: Lambert
authors: Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Anne
authors: A
authors: Karow
authors: Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
authors: Mathias
authors: M
authors: Zink
authors: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors: Hendrik
authors: H
authors: Müller
authors: Department of Psychiatry and Psychotherapy, Charite University Medicine Campus Mitte, Berlin, Germany.
authors: Andreas
authors: A
authors: Heinz
authors: Department of Psychiatry and Psychotherapy, Charite University Medicine Campus Mitte, Berlin, Germany.
authors: Walter
authors: W
authors: de Millas
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
authors: Birgit
authors: B
authors: Janssen
authors: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.
authors: Wolfgang
authors: W
authors: Gaebel
authors: Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen, Aachen, Germany.
authors: Frank
authors: F
authors: Schneider
authors: Psychosis Centre, Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
authors: Dieter
authors: D
authors: Naber
authors: Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, Germany.
authors: Georg
authors: G
authors: Juckel
authors: Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Bochum, Germany.
authors: Seza
authors: S
authors: Krüger-Özgürdal
authors: Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, Göttingen and Centre of Mental Health, County Hospitals Darmstadt-Dieburg, Gross-Umstadt, Germany.
authors: Thomas
authors: T
authors: Wobrock
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors: Michael
authors: M
authors: Wagner
authors: Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.
authors: Wolfgang
authors: W
authors: Maier
authors: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors: Joachim
authors: J
authors: Klosterkötter
authors: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors: Andreas
authors: A
authors: Bechdolf
mesh_terms: D000328:Adult; D017668:Age of Onset; D005260:Female; D006801:Humans; D008297:Male; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012727:Sex Characteristics; D012919:Social Behavior; D055815:Young Adult
keywords: gender; negative symptom; prodrome; psychosis; social functioning