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

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.