Ritsner Michael, Gibel Anatoly, Maayan Rachel, Ratner Yael, Ram Edward, Biadsy Hassan, Modai Ilan, Weizman Abraham
Sha'ar Menashe Mental Health Center, Mobile Post Hefer, 38814 Hadera, Israel.
Neuropsychopharmacology. 2005 Oct;30(10):1913-22. doi: 10.1038/sj.npp.1300747.
Dehydroepiandrosterone (DHEA) or their sulfate conjugate (DHEAS) (together abbreviated DHEA(S)) exert multiple effects in the central nervous system, and may be involved in the pathophysiological processes in schizophrenia. This prospective study aimed to investigate whether serum cortisol/DHEA(S) molar ratios are associated with response to antipsychotic treatment during the exacerbation of schizophrenia. Serum DHEA(S) and cortisol were determined at baseline, and 2 and 4 weeks later for 43 medicated schizophrenia inpatients with acute exacerbation. The patients were treated with stable doses of antipsychotic agents up to 2 weeks prior to entering the study and for the 4-week duration of the study after which they were classified as either responders or nonresponders to treatment. Findings suggest that responders had significantly higher serum cortisol levels and cortisol/DHEA(S) ratios compared with nonresponders. These differences remained significant at three time points controlling for gender, age, severity of symptoms and emotional distress, benzodiazepines, type or dosage of antipsychotic agents, and background variables. The logistic regression model shows advantages of both cortisol/DHEA(S) molar ratios vs serum cortisol and DHEA(S) concentrations for prediction of responsivity to antipsychotic treatment. No significant canonical correlations were observed between changes from baseline through end-of-study in hormonal values and severity of symptoms and emotional distress among responders and nonresponders. Thus, these data provide evidence that elevated serum cortisol and cortisol/DHEA(S) ratios may serve as markers of biological mechanisms that are involved in responsivity of schizophrenia patients to antipsychotic treatment.
脱氢表雄酮（DHEA）或其硫酸酯共轭物（DHEAS）（合称DHEA(S)）在中枢神经系统中发挥多种作用，可能参与精神分裂症的病理生理过程。这项前瞻性研究旨在调查血清皮质醇/DHEA(S)摩尔比是否与精神分裂症急性加重期抗精神病药物治疗的反应相关。对43例急性加重期的药物治疗的精神分裂症住院患者，在基线、2周和4周后测定血清DHEA(S)和皮质醇。在进入研究前2周内，患者接受稳定剂量的抗精神病药物治疗，研究为期4周，之后将患者分为治疗反应者或无反应者。研究结果表明，与无反应者相比，反应者的血清皮质醇水平和皮质醇/DHEA(S)比值显著更高。在控制性别、年龄、症状严重程度和情绪困扰、苯二氮䓬类药物、抗精神病药物类型或剂量以及背景变量的三个时间点，这些差异仍然显著。逻辑回归模型显示，皮质醇/DHEA(S)摩尔比与血清皮质醇和DHEA(S)浓度在预测抗精神病药物治疗反应性方面均具有优势。在反应者和无反应者中，从基线到研究结束激素值的变化与症状严重程度和情绪困扰之间未观察到显著的典型相关性。因此，这些数据提供了证据，表明血清皮质醇和皮质醇/DHEA(S)比值升高可能作为精神分裂症患者对抗精神病药物治疗反应性所涉及的生物学机制的标志物。
