Sexual dysfunction in drug- naïve first episode nonaffective psychosis patients. Relationship with prolactin and psychotic symptoms. Gender differences.

BACKGROUND: Our aim is to examine differences in sexual functioning (SF) between patients with drug-naïve first episode psychosis (FEP) and healthy controls (HC). We will also examine correlations between prolactin levels, testosterone levels and psychotic symptomatology with SF from a gender perspective. METHODS: Cross-sectional study. We included 68 FEP patients and 50 HC. A blood sample was extracted. We used the Positive and Negative Syndrome Scale to assess symptom severity, using the five factor structure according to Emsley. The Changes in Sexual Function Questionnaire (CSFQ) was administered. RESULTS: We found significantly better SF in HC than in patients (in CSFQ total score (p = 0.032) and in CSFQ Desire (p = 0.032)). A significant correlation between prolactin or testosterone and SF was not observed. We found a negative significant correlation between the disorganised subscale of the EMSLEY and total CSFQ (p = 0.027; r = -0.329), CSFQ Desire (p = 0.028; r = -0.329) and CSFQ Arousal (p = 0.026; r = -0.332) in the patient sample. In a regression model, we found sex (p = 0.003) and disorganized symptoms (p = 0.034) as significant predictors. CONCLUSIONS: We found evidence for better SF in HC than in FEP patients. We could not confirm an association between prolactin or testosterone and SF. Disorganized symptomatology could be a relevant factor in SF.

Prolactin levels in drug-naïve first episode nonaffective psychosis patients compared with healthy controls. Sex differences.

Recent studies have found hyperprolactinemia in first episode psychotic patients that had not previously received antipsychotic treatment (drug-naïve). Our goal was to learn whether there were differences in baseline prolactin concentrations between drug-naïve psychotic patients and healthy controls, as well as to study possible gender differences in the prolactin elevation. A cross-sectional study was conducted that included 61 drug-naïve psychosis patients and 45 healthy controls (aged between 14-55 years old). A blood sample was extracted between 8 and 10 a.m. Prolactin levels and TSH were determined. The Perceived Stress Scale (PSS) was conducted across the sample. This study showed significantly higher levels of prolactin in drug-naïve patients compared to healthy controls. These results were maintained after controlling prolactin levels for sex, age, THC consumption, baseline TSH, and PSS. A significant correlation between prolactin and PSS was not observed. Significant differences in prolactin levels between men and women were not observed. These results are clinically important because if elevated baseline prolactin levels are detected in these patients, it will be necessary to initiate neuroleptics that do not increase this hormone. There was no evidence that stress was related to an increase in prolactin at the onset of psychosis.

Birth weight and obstetric complications determine age at onset in first episode of psychosis.

BACKGROUND: Earlier age at onset of psychosis (AOP) has been associated with poor social adjustment and clinical outcome. Genetic and environmental factors such as obstetric complications, parental history of psychosis, advanced paternal age at time of birth, low birth weight and gestational age, and use of drugs have been described as bringing AOP forward. This study aims to evaluate the relationship between AOP and these factors in a sample of first episode of psychosis (FEP) patients. METHODS: Clinical and sociodemographic data, age at FEP, age of parents at birth, parental history of psychosis, drug-use habits of the mother during pregnancy and of the patient before psychotic onset, and Lewis and Murray obstetric complication scale were obtained from 90 patients with FEP. Statistical analysis was performed by means of Pearson correlations, Chi-square tests, Student T-test analyses and a linear regression model using SPSS version 22. RESULTS: Pre-eclampsia, need for incubator at birth, use of forceps, parental history of psychosis, and low birth weight were associated with an earlier AOP. Use of forceps and birth weight are the variables which best predict AOP in FEP. Stimulant drugs, which were mostly used together with cannabis and cocaine, were the only substances associated with an earlier AOP. CONCLUSIONS: Our findings are consistent with previous study results and underline the role of the prenatal period in the development of psychosis and the importance of careful monitoring of pregnancy and delivery, especially in cases with familial history.