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Peer-reviewedCC BY 4.0European Child & Adolescent Psychiatry

Sex-specific clinical profiles and long-term outcomes in adolescents and young people at clinical high risk for psychosis: Findings from the PARMS program

  • Lorenzo Pelizza1,2,3
  • Camilla Ricci1
  • Emanuela Leuci2
  • Emanuela Quattrone2
  • Derna Palmisano2
  • Simona Pupo4
  • Giuseppina Paulillo2
  • Clara Pellegrini2
  • Pietro Pellegrini2
  • Marco Menchetti1
4 affiliations
  1. 1Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum – Università di Bologna, Bologna (BO), Italy
  2. 2Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Parma, PR Italy
  3. 3Istituto di Psichiatria “Paolo Ottonello” - via Pepoli, Bologna (BO), 5 - 40126 Italy
  4. 4Pain Therapy Service, Department of Medicine and Surgery, Azienda Ospedaliero-Universitaria di Parma, Parma, PR Italy
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Abstract

Males with first episode psychosis (FEP) show poorer premorbid functioning, more severe psychopathology, and lower functional remission than females. Preliminary evidence suggests that even in Clinical High-Risk for Psychosis (CHR-P), males and females differ in clinical and psychosocial profiles. However, further investigations are needed, especially about outcomes and in adolescents. This study aimed to examine sex differences in clinical/functional presentation and longitudinal outcomes between CHR-P men and women assessing the impact of specialized “Early Intervention in Psychosis” (EIP) interventions over a two-year follow-up within an Italian program. 179 CHR-P men and women (90 females, 89 males; aged 12–25 years) were assessed using the Health of the Nation Outcome Scale and the Positive and Negative Syndrome Scale at baseline and annually for two years. Of them, 152 (76 males, 76 females) completed the follow-up. At baseline, males were older, had higher rates of substance use and unemployment, more severe negative symptoms, and poorer insight. They frequently suffered from brief limited, intermittent psychotic symptoms, whereas females predominantly from attenuated psychotic symptoms. Over two years, females showed a significantly higher rate of functional remission. Specialist EIP interventions increased across time and potentially contributed to improve outcomes in both sexes. Sex differences are evident at baseline in CHR-P participants, especially regarding psychopathology and social functioning. Nonetheless, clinical trajectories over time are largely comparable, except for greater functional recovery in females. These findings support the time effects of our early interventions regardless of sex but emphasize to further explore sex-specific pathways in psychosis risk and recovery.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00787-026-03082-8.

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Cite

BibTeXRIS
BibTeX
@article{pelizza2026sexspecific,
  title = {{Sex-specific clinical profiles and long-term outcomes in adolescents and young people at clinical high risk for psychosis: Findings from the PARMS program}},
  author = {Lorenzo Pelizza and Camilla Ricci and Emanuela Leuci and Emanuela Quattrone and Derna Palmisano and Simona Pupo and Giuseppina Paulillo and Clara Pellegrini and Pietro Pellegrini and Marco Menchetti},
  journal = {European Child \& Adolescent Psychiatry},
  year = {2026},
  month = jun,
  doi = {10.1007/s00787-026-03082-8},
  url = {https://doi.org/10.1007/s00787-026-03082-8},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Sex-specific clinical profiles and long-term outcomes in adolescents and young people at clinical high risk for psychosis: Findings from the PARMS program
AU  - Lorenzo Pelizza
AU  - Camilla Ricci
AU  - Emanuela Leuci
AU  - Emanuela Quattrone
AU  - Derna Palmisano
AU  - Simona Pupo
AU  - Giuseppina Paulillo
AU  - Clara Pellegrini
AU  - Pietro Pellegrini
AU  - Marco Menchetti
PY  - 2026
DA  - 2026/06/04
JO  - European Child & Adolescent Psychiatry
DO  - 10.1007/s00787-026-03082-8
UR  - https://doi.org/10.1007/s00787-026-03082-8
AB  - Males with first episode psychosis (FEP) show poorer premorbid functioning, more severe psychopathology, and lower functional remission than females. Preliminary evidence suggests that even in Clinical High-Risk for Psychosis (CHR-P), males and females differ in clinical and psychosocial profiles. However, further investigations are needed, especially about outcomes and in adolescents. This study aimed to examine sex differences in clinical/functional presentation and longitudinal outcomes between CHR-P men and women assessing the impact of specialized “Early Intervention in Psychosis” (EIP) interventions over a two-year follow-up within an Italian program. 179 CHR-P men and women (90 females, 89 males; aged 12–25 years) were assessed using the Health of the Nation Outcome Scale and the Positive and Negative Syndrome Scale at baseline and annually for two years. Of them, 152 (76 males, 76 females) completed the follow-up. At baseline, males were older, had higher rates of substance use and unemployment, more severe negative symptoms, and poorer insight. They frequently suffered from brief limited, intermittent psychotic symptoms, whereas females predominantly from attenuated psychotic symptoms. Over two years, females showed a significantly higher rate of functional remission. Specialist EIP interventions increased across time and potentially contributed to improve outcomes in both sexes. Sex differences are evident at baseline in CHR-P participants, especially regarding psychopathology and social functioning. Nonetheless, clinical trajectories over time are largely comparable, except for greater functional recovery in females. These findings support the time effects of our early interventions regardless of sex but emphasize to further explore sex-specific pathways in psychosis risk and recovery.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00787-026-03082-8.
SN  - 1018-8827
SN  - 1435-165X
ER  -