title: Gender differences in the treatment of first-episode schizophrenia: Results from the European First Episode Schizophrenia Trial.
abstract: Gender differences in the response to antipsychotic treatment have been detected in the past, but not studied in great detail. The results of the European First-Episode Schizophrenia Trial (EUFEST) were analyzed with a focus on gender differences in the response to randomized treatment of first-episode schizophrenia. A total of 498 patients (298 men and 200 women) were randomly assigned by a web-based online system to open-label treatment with haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone. Treatment response was evaluated using the positive and negative syndrome scale (PANSS). Data were collected at baseline and then prospectively for one year. Baseline characteristics (age and proportion of patients assigned to individual antipsychotics) were the same between the male and female patients with the exception of ziprasidone: significantly fewer men, proportionately, were prescribed ziprasidone. There was no significant difference between genders between the initial total PANSS and subscale scores. A significant interaction between time and gender was found, with more robust PPANSS and TPANSS score improvement in women during the course of treatment. Of all of the antipsychotics used, only olanzapine led to significantly greater improvement in the total PANSS score in women during the follow-up period. Gender differences should be given more attention in research and clinical practice. Their causes require clarification, and future strategies for dealing with them may be considered in early intervention programs and guidelines.
authors.affiliation: Department of Psychiatry, Faculty Hospital Brno, Czech Republic; Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic; Department of Clinical Studies Medical Faculty, University Ostrava, Czech Republic; Department of Psychiatry, Faculty Hospital Ostrava, Czech Republic. Electronic address: eva.ceskova@gmail.com.
authors.forename: Eva
authors.initials: E
authors.lastname: Ceskova
authors.affiliation: Department of Psychiatry, Faculty Hospital Brno, Czech Republic; Central European Institute of Technology, Masaryk University (CEITEC MU), Brno, Czech Republic.
authors.forename: Radovan
authors.initials: R
authors.lastname: Prikryl
authors.affiliation: Department of Psychiatry, University Hospital Hradec Kralove, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Libiger
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Svancara
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005060:Europe; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000188:drug therapy*; D012727:Sex Characteristics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; First-episode schizophrenia; Gender differences; Treatment response