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Sex-based differences in neurocognitive functioning in first-episode psychosis: An exploratory analysis.

Marina Verdaguer-Rodríguez1, Raquel López-Carrilero2, Luciana Díaz-Cutraro3

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Sex differences in first-episode psychosis (FEP) impact verbal memory and executive functions. Women show advantages in executive functioning, while men use different memory strategies, influenced by diagnosis and education.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Psychology

Background:

  • Inconsistent evidence exists regarding sex differences in neurocognition among individuals with first-episode psychosis (FEP).
  • Previous studies have not consistently accounted for clinical and sociodemographic factors that may influence these differences.

Purpose of the Study:

  • To investigate sex-based differences in neurocognition within a first-episode psychosis (FEP) cohort.
  • To explore the impact of clinical and sociodemographic covariates on observed sex differences in cognitive performance.

Main Methods:

  • An observational descriptive study was conducted with 191 individuals diagnosed with first-episode psychosis (FEP).
  • Participants completed a comprehensive neuropsychological battery assessing various cognitive domains.
  • Statistical analyses, including ANCOVAs, were used to compare cognitive performance between men and women, adjusting for relevant covariates.

Main Results:

  • After covariate adjustment, men demonstrated more frequent use of serial clustering in short-term recall tasks compared to women.
  • Women outperformed men on the Wisconsin Card Sorting Test, with education level significantly influencing performance.
  • Verbal memory recall (immediate and long-term) and clustering strategies were associated with education level and diagnosis.

Conclusions:

  • Sex differences are evident in verbal memory and executive functioning in first-episode psychosis (FEP).
  • Cognitive performance is influenced by encoding strategies, diagnosis, and education level.
  • Interventions for FEP should adopt an intersectional approach to optimize cognitive rehabilitation by addressing specific sex- and education-related needs.