Males and females with first episode psychosis present distinct profiles of social cognition and metacognition

Abstract

Defcits in social cognition and metacognition impact the course of psychosis. Sex diferences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with frst-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profle analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specifc male profle characterized by presenting jumping to conclusions (28.7%) and a specifc female profle characterized by cognitive biases (12.1%). Males and females in the homogeneous profle seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological defcits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may beneft from specifc targeted treatment and highlights the need to consider sex when planning interventions.