Hochman Karen M, Lewine Richard R
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, c/o 206 Edgewood Avenue SE, Atlanta, GA 30303, USA.
Schizophr Res. 2004 Aug 1;69(2-3):183-8. doi: 10.1016/s0920-9964(03)00176-2.
The "estrogen hypothesis" posits that this hormone serves as a protective factor in the development of schizophrenia. If true, then it is expected that the earlier the age of menarche, the later the onset of schizophrenia (as has been reported by some investigators). This study attempts to replicate this relationship in a sample of women with schizophrenia and schizoaffective disorder.
Self-report menarche age, clinical status, and onset of disorder were collected in a sample of 68 women (55 diagnosed with schizophrenia and 13 with schizoaffective disorder).
Menarche age and schizophrenia onset were not negatively correlated as would be predicted by the estrogen hypothesis. Two clinical measures, however, did correlate with age of menarche as predicted. Higher negative symptom scores (total SANS) and greater functional impairment (lower GAF) were reported in subjects who reported a later age at menarche.
This study suggests that an earlier age at menarche might predict improved clinical outcome after schizophrenia onset (in support of the estrogen hypothesis). Our data, however, do not support Cohen et al.'s findings regarding the relationship between age at menarche, and the timing of the onset of the disorder. Further investigations regarding the relationship between estrogen and schizophrenia development in women are needed. It is suggested that other developmental factors, both biological and psychosocial, might play a crucial role in both the age at onset and the outcome of the disorder in women.
“雌激素假说”认为这种激素在精神分裂症的发病过程中起到保护作用。如果这一假说成立，那么月经初潮年龄越早，精神分裂症发病越晚（一些研究者曾有此报道）。本研究试图在一组患有精神分裂症和分裂情感性障碍的女性样本中重现这种关系。
收集了68名女性（55名被诊断为精神分裂症，13名患有分裂情感性障碍）的自我报告月经初潮年龄、临床状态及疾病发病情况。
月经初潮年龄与精神分裂症发病并未如雌激素假说所预测的那样呈负相关。然而，有两项临床指标确实如预期那样与月经初潮年龄相关。月经初潮年龄较晚的受试者报告了更高的阴性症状评分（总SANS）和更严重的功能损害（更低的GAF）。
本研究表明月经初潮年龄较早可能预示着精神分裂症发病后临床预后更好（支持雌激素假说）。然而，我们的数据并不支持科恩等人关于月经初潮年龄与疾病发病时间之间关系的研究结果。需要进一步研究雌激素与女性精神分裂症发病之间的关系。建议其他发育因素，包括生物学和心理社会因素，可能在女性疾病的发病年龄和预后中起关键作用。
