Negative symptoms and sex differences in first episode schizophrenia: What's their role in the functional outcome? A longitudinal study

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• dc.contributor.author Amoretti, Silvia
• dc.contributor.author Trabsa, Amira
• dc.contributor.author 2EPs Group
• dc.date.accessioned 2025-07-18T05:50:22Z
• dc.date.available 2025-07-18T05:50:22Z
• dc.date.issued 2025
• dc.description.abstract Introduction: Negative symptoms (NS) include asociality, avolition, anhedonia, alogia, and blunted affect and are linked to poor prognosis. It has been suggested that they reflect two different factors: diminished expression (EXP) (blunted affect and alogia) and amotivation/pleasure (MAP) (anhedonia, avolition, asociality). The aim of this article was to examine potential sex differences among first-episode schizophrenia (FES) patients and analyze sex-related predictors of two NS symptoms factors (EXP and MAP) and functional outcome. Material and methods: Two hundred and twenty-three FES (71 females and 152 males) were included and evaluated at baseline, six-months and one-year. Repeated measures ANOVA was used to examine the effects of time and sex on NS and a multiple linear regression backward elimination was performed to predict NS factors (MAP-EXP) and functioning. Results: Females showed fewer NS (p=0.031; Cohen's d=-0.312), especially those related to EXP (p=0.024; Cohen's d=-0.326) rather than MAP (p=0.086), than males. In both male and female group, worse premorbid adjustment and higher depressive symptoms made a significant contribution to the presence of higher deficits in EXP at one-year follow-up, while positive and depressive symptoms predicted alterations in MAP. Finally, in females, lower deficits in MAP and better premorbid adjustment predicted better functioning at one-year follow-up (R2=0.494; p<0.001), while only higher deficits in MAP predicted worse functioning in males (R2=0.088; p=0.012). Conclusions: Slightly sex differences have been found in this study. Our results lead us to consider that early interventions of NS, especially those focusing on motivation and pleasure symptoms, could improve functional outcomes.
• dc.description.sponsorship The study has been supported by a BITRECS project conceded to N. Verdolini. BITRECS project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 754550 and from “La Caixa” Foundation.
• dc.format.mimetype application/pdf
• dc.identifier.citation Amoretti S, Mezquida G, Verdolini N, Bioque M, Sánchez-Torres AM, Pina-Camacho L, Zorrilla I, et al. Negative symptoms and sex differences in first episode schizophrenia: What's their role in the functional outcome? A longitudinal study. Span J Psychiatry Ment Health. 2025 Apr-Jun;18(2):91-9. DOI: 10.1016/j.sjpmh.2023.04.001
• dc.identifier.doi http://dx.doi.org/10.1016/j.sjpmh.2023.04.001
• dc.identifier.issn 2950-2853
• dc.identifier.uri http://hdl.handle.net/10230/70947
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Span J Psychiatry Ment Health. 2025 Apr-Jun;18(2):91-9
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/754550
• dc.rights © 2023 The Authors. Published by Elsevier España, S.L.U. on behalf of Sociedad Española de Psiquiatría y Salud Mental (SEPSM). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword First-episode of psychosis
• dc.subject.keyword Functional outcome
• dc.subject.keyword Negative symptoms
• dc.subject.keyword Schizophrenia
• dc.subject.keyword Sex
• dc.title Negative symptoms and sex differences in first episode schizophrenia: What's their role in the functional outcome? A longitudinal study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion