Gender differences in correlates of neurocognition and functioning in first-episode psychosis

Abstract

OBJECTIVE: Gender differences are extensively studied in schizophrenia, with distinct profiles in demography, symptoms, and prognosis. However, findings in cognitive functioning have been mixed.1,2 This study examined sex differences in associations between demographics, symptoms and cognition, and investigated predictors of cognition in a large sample of patients with first-episode psychosis (FEP) in Hong Kong. METHODS: A total of 360 adult-onset FEP patients were administered a comprehensive battery of neurocognitive tests upon admission into a specialised early intervention service. Detailed demographic, clinical, and functioning data were also collected. RESULTS: Bivariate correlation analysis showed that duration of untreated psychosis was significantly associated with affective symptom severity in men. Memory and working memory were more significantly associated with onset age, negative symptoms, and side-effects in women. Processing speed was associated with antipsychotic dosage in men and side-effects in women. Selective attention was associated with positive and negative symptoms in women, and onset age and educational level in men. Executive function was associated with onset age and positive symptoms in women. All cognitive domains were significantly associated with educational level and functioning in both genders. Duration of untreated psychosis and disorganisation had no significant correlations. Linear regression analysis demonstrated that negative symptoms were predictive of cognition in both genders, while positive symptoms, medication side-effects, and affective symptoms were predictors in men and women, respectively. CONCLUSION: The data suggest that although there are common correlates, considerable heterogeneity exists in associations of symptoms and cognitive performance in men and women. Findings can inform more gender-specific tailoring of clinical treatment plans, such as cognitive remediation therapy.