What question did this study set out to answer?

To examine sex differences in psychotic symptoms and their clinical correlates in first-episode drug-naïve patients with bipolar disorder.

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April 10, 2026Open Access

Sex differences in prevalence and clinical correlates for psychotic symptoms in first-episode drug-naïve patients with bipolar disorder: a cross-sectional study

Key Points

To examine sex differences in psychotic symptoms and their clinical correlates in first-episode drug-naïve patients with bipolar disorder.
Cross-sectional study design
Sample included Han Chinese first-episode drug-naïve bipolar disorder patients
Assessment of psychotic symptoms and metabolic-endocrine indicators
No significant sex difference in the prevalence of psychotic symptoms
HDL-C shows protective effects against psychotic symptoms in both sexes
Metabolic syndrome correlates with symptoms in males, while TSH is significant for females

Abstract

Among Han Chinese FEDN BD patients, our study revealed the following: (1) No significant sex difference was observed in the prevalence of psychotic symptoms; (2) HDL-C functions as a meaningful protective factor against the prevalence of psychotic symptoms in both males and females, while its association with symptom severity is observed exclusively in females; (3) Sex-specific indicators correlate with psychotic symptoms, specifically MetS dominates in males, while TSH in females. Our results call for sex-informed clinical protocols that integrate metabolic-endocrine monitoring and targeted interventions to reduce psychosis risk in BD.

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