Sex Differences in Recovery-Related Outcomes and Needs for Psychiatric Rehabilitation in People With Schizophrenia Spectrum Disorder

Marine Dubreucq, MSc^a,b,* ; Julien Plasse, MSc^c,d ; Franck Gabayet, MSc^a,b ; Olivier Blanc, MD^e ; Isabelle Chereau, MD^b,e ; Sophie Cervello, MD^c,d,f ; Geoffroy Couhet, MD^g ; Caroline Demily, MD, PhD^f,h ; Nathalie Guillard-Bouhet, MDⁱ ; Benjamin Gouache, MD^a ; Nemat Jaafari, MD, PhDⁱ ; Guillaume Legrand, MD^j ; Emilie Legros-Lafarge, MD^k ; Geneviève Mora, MD^j ; Romain Pommier, MD^l ; Clélia Quilès, MD^m ; Hélène Verdoux, MD, PhD^m ; Francis Vignaga, MDⁿ ; Catherine Massoubre, MD, PhD^l ; Nicolas Franck, MD, PhD^c,d,f ; Julien Dubreucq, MD, PhD^a,b,f,o

J Clin Psychiatry 2021;82(4):20m13732

ABSTRACT

Background: Female sex/gender has been associated with better longitudinal outcomes in schizophrenia spectrum disorders (SSDs). Few studies have investigated the relationships between female gender and recovery-related outcomes. Women’s specific psychiatric rehabilitation needs remain largely unknown.

Objective: The objectives of the present study are to investigate sex differences in (1) objective and subjective aspects of recovery and (2) psychiatric rehabilitation needs in a multicenter non-selected psychiatric rehabilitation SSD sample.

Methods: 1,055 outpatients with SSD (DSM-5) were recruited from the French National Centers of Reference for Psychiatric Rehabilitation (REHABase) cohort between January 2016 and November 2019. Evaluation included standardized scales for quality of life, satisfaction with life, and well-being and a broad cognitive battery. Socially valued roles at enrollment were recorded. Functional recovery was measured using the Global Assessment of Functioning scale (GAF) and personal recovery with the Stages of Recovery Instrument (STORI).

Results: Female sex was the best predictor of having more than 2 socially valued roles in the multivariate analysis (P < .001; OR [95% CI] = 5.42 [2.34–13.06]). No sex differences were found for functional recovery or personal recovery. Female gender was positively associated with self-stigma (P = .036) and suicidal history (P < .001) and negatively correlated with quality of life (P = .004) and satisfaction with interpersonal relationships (P = .029), an area in which women reported more unmet needs (P = .004).

Conclusions: The present study found that women had poorer subjective recovery-related outcomes and more unmet needs than men. It would therefore be beneficial to develop recovery-oriented interventions addressing women’s specific needs and implement these in psychiatric rehabilitation services.

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