Sex differences and age of onset in recovery and well-being in people with psychotic disorders

Linda HOEKSEMA1,2, Jojanneke BRUINS1, Marieke TIMMERMAN2, Stynke CASTELEIN1,2

1Lentis, Groningen, Netherlands
2University of Groningen, Groningen, Netherlands

Introduction

Considering the significant knowledge gaps regarding women's health, as highlighted by the World Health Organization, this study focusses on sex differences in people with psychosis. Women are thought to have a more favourable course of psychotic illness than men, although this might only apply to early onset psychosis. Next, little is known about sex differences in more subjective outcomes such as recovery and well-being. This study longitudinally examines sex related differences and age of onset in recovery and well-being of people with a psychotic disorder.

Methods

Routine outcome monitoring data of n=3843 patients were used from yearly screenings between 2012-2021. Clinical-, societal- and personal recovery were assessed, as well as quality of life and psychosocial functioning. Four groups were created: men (n=2276) and women (n=1111) with early onset psychosis (<41 years old) and men (n=217) and women (n=239) with late onset psychosis (>40 years old). Latent growth mixture modelling (LGMM) was performed to assess different patterns of recovery and well-being.

Results

LGMM identified five classes of recovery and well-being patterns. Sex had a significant main effect on the distribution across the five classes (\chi ^{^{2}}=55.2; p<0.001), whereas there was no main effect for age of onset (\chi ^{^{2}}=10.5; p=0.033). There was a sex-age of onset interaction effect where women with late onset had the highest chance to be in higher functioning classes (\chi ^{^{2}}=65.8; p<0.001).

Discussion-conclusion

This study shows sex differences in long-term recovery patterns of psychosis. Women indeed showed more favourable recovery and well-being patterns, especially with late onset psychosis, while men with early onset of psychosis had the least favourable recovery patterns. The different recovery patterns were relatively stable and showed minimal changes over time. Addressing these sex differences in policy and treatment protocols might provide better mental health care to people with psychosis.