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Gender and duration of untreated psychosis: a systematic review and meta-analysis

Authors

  • Maria Teresa Cascio,

    1. Programma 2000 – Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan
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  • Matteo Cella,

    1. Department of Clinical and Health Psychology, University College of London
    2. Department of Psychology, Institute of Psychiatry, King's College London, London, UK
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  • Antonio Preti,

    Corresponding author
    1. Programma 2000 – Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan
    2. Genneruxi Medical Center, Psychiatry Branch, Cagliari, Italy
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  • Anna Meneghelli,

    1. Programma 2000 – Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan
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  • Angelo Cocchi

    1. Programma 2000 – Center for Early Detection and Intervention in Psychosis, Department of Mental Health, Niguarda Ca' Granda Hospital, Milan
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Dr Antonio Preti, Centro Medico Genneruxi, Psychiatry, Via Costantinopoli 42, 09129 Cagliari, Italy. Email: apreti@tin.it

Abstract

Aim: Duration of untreated psychosis (DUP) can influence the prognosis of schizophrenia. Previous studies have suggested that gender may influence the length of DUP. This study reports the result of the first systematic literature review and meta-analysis on the role of gender in influencing DUP in first-episode psychosis.

Method: Systematic literature search in PubMed/Medline and Ovid/PsychINFO. Twenty-seven studies presenting data on 4721 patients diagnosed with psychosis at their first episode (2834 males and 1887 females) were included in the analysis.

Results: Samples had a higher proportion of males: odds ratio = 2.5 (95% confidence interval: 1.8–3.3). Mean age at first contact was 25.4 for males and 27.5 for females. Patients from non-Western countries were older at first contact than patients from Western countries. Average DUP in schizophrenia was 64 weeks and did not differ between genders but was shorter in Western compared with non-Western countries.

Conclusion: Earlier age at first contact and larger incidence in males support the existence of specific gender differences in first-episode psychosis; however, these are not associated with DUP length.

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