ArticleBMJ open2021
Gender differences in clinical presentation and illicit substance use during first episode psychosis: a natural language processing, electronic case register study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Sex differences in schizophrenia: symptomatology, treatment efficacy and adverse effects.Frontiers in psychiatry · 2025Pooled it
- Sex and gender differences in symptoms of early psychosis: a systematic review and meta-analysis.Archives of women's mental health · 2022Pooled it
- Gender differences in outcomes of early intervention services for first episode psychosis.Early intervention in psychiatry · 2023Trial
- Demographic and clinical profiles of drug-induced psychosis: age, gender, and social context in a German cohort.European archives of psychiatry and clinical neuroscience · 2026Article
- Prevalence and clinical correlates of suicidal ideation and aggression in patients with chronic schizophrenia: large-scale, cross-sectional study.BJPsych open · 2026Article
- Cannabis Use and Clinical Outcomes in First Episode Psychosis: Results From a 2-Year Follow-Up Study.Early intervention in psychiatry · 2026Article
- Natural Language Processing for Substance Use Disorder Information Extraction: A Systematic Literature Review.Current addiction reports · 2026Review
- Sex comparisons on the beneficial effects of an early intervention program in a patients' cohort with first episode psychosis: what effectiveness in women?Archives of women's mental health · 2025Article
- Natural language processing application to identify covert administration of medicines: development and pilot audit.BJPsych bulletin · 2025Article
- NGF-β and BDNF levels are altered in male patients with chronic schizophrenia: effects on clinical symptoms.BMC psychiatry · 2025Article
- Sex differences in outcomes of first episode psychosis: results from an early intervention service.Frontiers in behavioral neuroscience · 2025Article
- Associations of psychotic symptom dimensions with clinical and developmental variables in twin and general clinical samples.The British journal of psychiatry : the journal of mental science · 2025Article
- Sex differences in the association of overweight with cognitive performance in individuals with first-episode psychosis.Schizophrenia (Heidelberg, Germany) · 2024Article
- Sex differences in patient-reported outcome measure of psychotic symptoms in schizophrenia.Archives of women's mental health · 2024Article
- Article
- The association of childhood trauma with depressive and negative symptoms in recent onset psychosis: a sex-specific analysis.Psychological medicine · 2023Article
- [Prevalence rate and risk factor analysis of nonalcoholic fatty liver disease in 115 female patients with schizophrenia].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Sex differences in the clinical presentation of early psychosis in a primary care setting.Archives of women's mental health · 2023Article
- Psychosocial stress, interpersonal sensitivity, and social withdrawal in clinical high risk for psychosis: a systematic review.Schizophrenia (Heidelberg, Germany) · 2023Review
- Recommended practices and ethical considerations for natural language processing-assisted observational research: A scoping review.Clinical and translational science · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveTo determine whether gender differences in symptom presentation at first episode psychosis (FEP) remain even when controlling for substance use, age and ethnicity, using natural language processing applied to electronic health records (EHRs). DESIGN, SETTING AND
participantsData were extracted from EHRs of 3350 people (62% male patients) who had presented to the South London and Maudsley NHS Trust with a FEP between 1 April 2007 and 31 March 2017. Logistic regression was used to examine gender differences in the presentation of positive, negative, depressive, mania and disorganisation symptoms. EXPOSURES FOR OBSERVATIONAL STUDIES: Gender (male vs female). MAIN OUTCOMES AND MEASURES: Presence of positive, negative, depressive, mania and disorganisation symptoms at initial clinical presentation.
resultsEight symptoms were significantly more prevalent in men (poverty of thought, negative symptoms, social withdrawal, poverty of speech, aggression, grandiosity, paranoia and agitation). Conversely, tearfulness, low energy, reduced appetite, low mood, pressured speech, mood instability, flight of ideas, guilt, mutism, insomnia, poor concentration, tangentiality and elation were more prevalent in women than men. Negative symptoms were more common among men (OR 1.85, 95% CI 1.33 to 2.62) and depressive and manic symptoms more common among women (OR 0.30, 95% CI 0.26 to 0.35). After adjustment for illicit substance use, the strength of associations between gender and negative, manic and depression symptoms increased, whereas gender differences in aggression, agitation, paranoia and grandiosity became insignificant.
conclusionsThere are clear gender differences in the clinical presentation of FEP. Our findings suggest that gender can have a substantial influence on the nature of clinical presentation in people with psychosis, and that this is only partly explained by exposure to illicit substance use.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.