Journal Article

DZNE-2026-00358

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Influence of Sex and Diagnosis on Clinical Variables and Neurocognitive Performance in Severe Mental Illness. Results From the PsyCourse Study.

Serra-Navarro, M. ; Heilbronner, M. ; Solé, B. ; Borràs, R. ; Martinez-Arán, A. ; Adorjan, K. ; Navarro-Flores, A. ; Oraki Kohshour, M. ; Reich-Erkelenz, D. ; Schulte, E. C. ; Senner, F. ; Anghelescu, I.-G. ; Arolt, V. ; Baune, B. T. ; Dannlowski, U. ; Dietrich, D. E. ; Fallgatter, A.Extern* ; Figge, C. ; Jäger, M. ; Juckel, G. ; Konrad, C. ; Reimer, J. ; Reininghaus, E. Z. ; Schmauß, M. ; Schmitt, A. ; Spitzer, C. ; Wiltfang, J.DZNE* ; Zimmermann, J. ; Papiol, S. ; Heilbronner, U. ; Falkai, P. ; Schulze, T. G. ; Vieta, E. ; Torrent, C. ; Budde, M. ; Amoretti, S.

2026
Wiley-Blackwell Oxford [u.a.]

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Please use a persistent id in citations: doi:10.1111/acps.70026

Abstract: Bipolar disorder (BD) and schizophrenia (SZ) are serious mental illnesses (SMI) with overlapping symptoms but distinct differences in onset and course. Sex differences are an area of growing interest in SMI. This study aims to examine potential interactions between sex and diagnosis across a broad range of variables, to compare males and females within SZ and BD, and to investigate sex-specific group differences.A total of 1516 individuals were included in a cross-sectional study using baseline data from the multicenter PsyCourse Study, including BD (n = 543), SZ (n = 517), and healthy controls (HC) (n = 456). Sociodemographic characteristics, clinical symptoms, psychosocial functioning, quality of life, neurocognitive performance, and somatic comorbidities were assessed. Generalized linear models were used to analyze differences between groups and sexes. False Discovery Rate (FDR) and Bonferroni post hoc comparisons were performed.Significant interactions were identified in age (p = 0.001), age at treatment (p = 0.05), illness duration (p = 0.03), illicit drug use (p = 0.01), and smoking (p = 0.05). Differences in substance use were observed across groups and sexes, with the highest rates found in males with SZ. The BD group showed better functioning and neurocognitive performance compared with the SZ group. Within the BD group, females reported better performance in verbal memory (p = 0.003) and psychomotor speed (p < 0.001) than males. Moreover, both females and males with SMI showed higher rates of thyroid alterations compared with HC (p = 0.01 for females and p = 0.002 for males).Significant sex differences were observed in substance use and somatic comorbidities. Interactions between diagnosis and sex underscore the importance of considering both factors in clinical assessments. These findings highlight the need to tailor sex-specific treatment for each patient. Further research is needed to explore the role of sex hormones and other biological and societal factors in the presentation and course of these disorders.

Keyword(s): Humans (MeSH) ; Male (MeSH) ; Female (MeSH) ; Adult (MeSH) ; Schizophrenia: physiopathology (MeSH) ; Schizophrenia: epidemiology (MeSH) ; Schizophrenia: diagnosis (MeSH) ; Bipolar Disorder: physiopathology (MeSH) ; Bipolar Disorder: epidemiology (MeSH) ; Bipolar Disorder: diagnosis (MeSH) ; Cross-Sectional Studies (MeSH) ; Middle Aged (MeSH) ; Sex Factors (MeSH) ; Comorbidity (MeSH) ; Neuropsychological Tests (MeSH) ; Substance-Related Disorders: epidemiology (MeSH) ; Quality of Life (MeSH) ; bipolar disorder ; neurocognition ; psychosocial functioning ; quality of life ; schizophrenia ; sex differences ; somatic disease

Note: This work was supported by the Deutsche Forschungsgemeinschaft

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Contributing Institute(s):

1. Molecular biomarkers for predictive diagnostics of neurodegenerative diseases (AG Wiltfang)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2026

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Current Contents - Social and Behavioral Sciences ; DEAL Wiley ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Social Sciences Citation Index ; Web of Science Core Collection

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