Male and female patients with first-episode psychoses (FEP) differ in many aspects such as age at onset, premorbid level of functioning and the type of psychotic symptoms. Gender differences in factors related to outcome are less studied. The aim was to study gender differences in determinants of outcome in FEP patients.

Eighty-one male and 72 female FEP patients were followed up during 5-years with a comprehensive assessment of sociodemographic, psychiatric, and neuropsychological investigations. The 5-year outcome was dichotomized into poor and favourable outcome based on the 6-months stable functional and symptomatic outcome.

Female patients with an early onset, a lower level of education and still living with parents at baseline had more often a poor outcome than male patients. Among female patients, those with a low level of education had a poorer Wechsler's Adult Intelligent Scale (WAIS; the full-scale and the verbal and performance subscales) score. Among males, no such associations were found. A poor pre-morbid level of functioning and a long duration of untreated psychosis (DUP) were related to a poor outcome both for male and female patients.

The results indicate that, for male and female FEP patients, there are different predictors of outcome. In addition of risk factors of a poor outcome in both genders such as a low level of pre-morbid functioning and a long DUP, a low level of education, living with parents and an early onset of illness should be noticed as risk factors for female patients