Gender Differences in the Experience of Psychosis

Background

Gender differences in the presentation and course of psychosis are well documented. However, there is a lack of research which examines gender differences in the subjective experience of psychosis at a content level.

Aims

This study aims to explore gender differences in the presentation and the thematic content of psychotic symptoms. In order to contextualise the research findings, the study will also explore additional demographic and causal factors that might explain any gender differences in presentation, including history of substance use and history of abuse.

Method

The electronic medical records of 160 users of Early Intervention for Psychosis Services were comprehensively reviewed. Clinician reports were used to collect quantitative and qualitative data pertaining to symptom presentation. A quantitative analysis of symptom presentation was conducted and a thematic analysis was used to explore themes in the content of psychotic symptoms.

Results

Men experienced a greater number of psychotic symptoms in total, as well as more delusions, negative symptoms and symptoms of thought disorder. Specifically, they were more likely to experience grandiose delusions, hostility, pressure of speech, thought withdrawal and avolition. Women experienced a greater number of hallucinations and were more likely to experience tactile hallucinations. Thematic analysis revealed that men were more likely to experience themes of being attacked or possessing extraordinary powers. Women were more likely to experience themes of people not being who they seem, hearing noises and the feeling of being touched. Further analyses suggested that gender differences in life experience, namely substance use and sexual abuse, may partially explain gender differences in psychotic symptoms and content.

Conclusion

Gender differences exist at both symptom and content levels. Psychotic experiences may be influenced by life experiences and sociocultural expectations of gender. Mental health services should attend to the meaning and content of psychotic symptoms, and to gender differences in the experience of psychosis.