AUTHOR=Serra-Navarro Maria , Amoretti Silvia , Verdolini Norma , Forte María Florencia , Sánchez-Torres Ana M. , Vieta Eduard , Clougher Derek , Lobo Antonio , González-Pinto Ana , Panadero Rocío , Roldán Alexandra , Carvalho André F. , de la Serna Elena , Toll Alba , Ramos-Quiroga J. A. , Torrent Carla , Cuesta Manuel J. , Bernardo Miguel , PEPs Group , González-Díaz Jairo , Barbosa Lucila , Diaz-Caneja Covadonga M. , Rapado-Castro Marta , Alemany Carlo , Avila-Parcet Aina , Zorrilla Iñaki , Gonzalez-Ortega Itxasco , De-la-Cámara Concepción , Saz Pedro , Nacher Juan , Lorente Esther , Legido Teresa , Casanovas Francesc , Arbelo Nestor , Ilzarbe Lidia , Castro-Fornieles Josefina , Baeza Immaculada , Contreras Fernando , Bascarán Teresa Bobes , González-Blanco Leticia , Segarra Echevarría Rafael , Zabala Rabadán Arantzazu , Rodriguez-Jimenez Roberto , Sanchez-Pastor Luis , Usall Judith , Butjosa Anna , Sarró Salvador , Ángeles García León María , Ibáñez Ángela , Moreno-Izco Lucía , Balanzá-Martinez Vicent TITLE=Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: differences between males and females JOURNAL=Frontiers in Psychiatry VOLUME=13 YEAR=2022 URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2022.982583 DOI=10.3389/fpsyt.2022.982583 ISSN=1664-0640 ABSTRACT=Background

Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset.

Materials and methods

The initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up.

Results

FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = −0.307, p = 0.012) were significantly associated with functioning.

Conclusion

Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended.