One-year stability of diagnosis in first-episode nonaffective psychosis: influence of sex

Can J Psychiatry. 2006 Oct;51(11):711-4. doi: 10.1177/070674370605101108.


Objective: To determine whether sex influences the frequency and direction of diagnostic change 1 year after a first episode of nonaffective psychosis.

Method: The subjects (n = 228) were individuals diagnosed with schizophrenia and other psychoses according to DSM-IV criteria at baseline and at 1 year.

Results: When diagnostic shifts occurred, men mainly shifted toward schizophrenia (84.6%), which was associated with more severe symptoms. In contrast, 72% of women in whom a diagnostic shift occurred shifted away from a schizophrenia spectrum disorder toward mood disorder. A shift to mood disorder in women was associated with an early age of illness onset.

Conclusions: At initial presentation, nonaffective first-episode psychosis studies may underestimate the number of men and overestimate the number of women who will eventually receive a schizophrenia diagnosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Humans
  • Incidence
  • Male
  • Mood Disorders / diagnosis
  • Mood Disorders / epidemiology
  • Mood Disorders / psychology
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / epidemiology*
  • Psychotic Disorders / psychology
  • Schizophrenia / diagnosis*
  • Schizophrenia / epidemiology*
  • Schizophrenic Psychology
  • Severity of Illness Index
  • Sex Distribution
  • Time Factors