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Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis

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Gender differences in first episode psychotic mania.

Sue M Cotton¹, Martin Lambert, Michael Berk

¹Orygen Youth Health Research Centre, University of Melbourne, Locked Bag 10 (35 Poplar Road), Parkville, Victoria, 3052, Australia. smcotton@unimelb.edu.au

|March 19, 2013

Summary

Gender significantly impacts first episode psychotic mania (FEPM). Males show higher substance use and forensic issues, while females report more sexual abuse trauma, influencing illness course and outcomes.

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Area of Science:

Psychiatry and Mental Health
Neuroscience
Clinical Psychology

Background:

First episode psychotic mania (FEPM) presents distinct challenges in diagnosis and treatment.
Understanding gender-specific differences in FEPM is crucial for tailored interventions.
Previous research has not fully elucidated the impact of gender on FEPM trajectories.

Purpose of the Study:

To investigate the influence of gender on premorbid history, symptom onset, and 18-month outcomes in patients with first episode psychotic mania.
To identify gender-specific risk factors and their association with clinical presentation and functional status in FEPM.
To inform clinical practice by highlighting gender-based disparities in the management of psychotic mania.

Main Methods:

A retrospective medical file audit was conducted on 118 patients diagnosed with FEPM, aged 15 to 29 years.
Data collection focused on clinical and functional measures, including premorbid history, substance use, trauma, illness severity, and functioning.
Statistical analysis, including odds ratios (OR), was used to compare male and female patient groups.

Main Results:

Males with FEPM exhibited higher rates of substance use (OR=13.41) and forensic issues (OR=4.71).
Females with FEPM were more likely to report a history of sexual abuse trauma (OR=7.12).
At service entry, males presented with greater illness severity (OR=1.72) and poorer functioning (OR=0.96), often linked to substance use (OR=2.15). During treatment, males showed improved substance use (OR=5.34) and family living situations (OR=4.30).

Conclusions:

Gender-specific risk factors significantly shape the course and outcomes of first episode psychotic mania.
Substance use in males with FEPM is associated with poorer clinical presentation and functioning.
The impact of sexual trauma on the illness course in females with FEPM requires further in-depth investigation and targeted support.