Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Robert Rosenheck

Second Advisor

Daniel Bennett

Abstract

BACKGROUNDThere has been growing interest in early intervention in psychotic disorders. However, gender differences in the outcomes of treatment have not been \studied in a clinical trial.

METHODSPatients diagnosed with schizophrenia or schizoaffective disorder with less than 6 months exposure to antipsychotics entered a cluster randomized trial of coordinated specialty care in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE-ETP). Secondary analyses examined gender differences in baseline characteristics as well as two-year gender outcomes, and the response to treatment controlling for baseline differences. Blinded evaluators assessed the Quality of Life Scale and the Positive and Negative Syndrome Scale (PANSS) every 6 months.

RESULTSAltogether 404 individuals aged 15-40 entered the study, of whom 111 (27.4%) were female and 293 (72.5%) were male. At baseline, women were significantly more likely to have been married (p=0.007) and to be living independently (p=0.012) than men. Women were also more likely to be diagnosed with schizoaffective disorder, bipolar type (p=0.006) and scored higher on the depression subscale of the PANSS (p=0.0004). Women were less likely to use or abuse cannabis (p=0.0004), though no less likely to use or abuse alcohol. Controlling for these differences, there were no significant gender differences in outcomes or response to treatment.

CONCLUSIONBaseline gender differences in comorbid substance use and prevalence of mood symptoms in women with FEP are consistent with previous studies. The absence of significant gender differences in outcomes or response to treatment has not been previously established in a multi-site trial.

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This is an Open Access Thesis.

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