Characteristics and Early Outcome of Deprived Women With Psychosis in Hong Kong

Abstract

Background: It has been reported that women facing financial hardship are more likely to be affected by mental illnesses, including depression and anxiety, in pregnant women. Whether similar differences exist in this disadvantaged subgroup among psychosis patients is, however, unclear. The current study aims to compare the baseline characteristics and early clinical and functioning outcome at 6 months between the financially deprived women with psychosis in Hong Kong and their nondeprived counterparts. Methods: Participants were recruited from a territory-wide early intervention program for adult (25–55 years old) psychosis patients in Hong Kong. Ninety-three financially deprived female patients and 105 nondeprived female patients were included. Their baseline demographics, premorbid, clinical, neurocognitive, and functioning characteristics were compared. The 6-month clinical and functioning outcome of the 2 groups were also compared. Results: At baseline, deprived women have higher PANSS score (P = .010), higher general psychopathology (P = .010), and higher SANS score in avolition-apathy (P = .003) and anhedonia-asociality (P = .008). In terms of functioning, deprived women have lower SOFAS score (P = .002) compared to nondeprived women. They also performed worse in age-adjusted WAIS-R information test (P = .001), WAIS-R arithmetic test (P = .002), WAIS-R forward digit span (P < .001), WAIS-R backward digit span (P = .003), visual patterns tests (P = .002), digit symbols (P < .001), and verbal fluency (P < .001). At 6 months, financially deprived women also have severer symptoms compared to nondeprived women, with higher SAPS scores (P = .045), higher SANS avolition-apathy scores (P = .005), higher scores in Calgary Depression Scale (P = .003). Also, deprived women have lower SOFAS score (P = .003). Conclusion: The current results shows that differences exist in baseline characteristics and early outcome between female patients with and without financial hardship. Deprived women have more severe symptoms, worse social and occupational functioning, and worse cognitive ability at baseline. Early outcome of deprived women was also found to be worse, with severer symptoms and worse social and occupation function. It shows that female psychosis patients facing financial hardship may require additional assistance and attention.