Bergemann Niels, Parzer Peter, Jaggy Susanne, Auler Beatrice, Mundt Christoph, Maier-Braunleder Sabine
Department of General Psychiatry, University of Heidelberg, Heidelberg, Germany.
Schizophr Bull. 2008 Nov;34(6):1172-81. doi: 10.1093/schbul/sbm138. Epub 2007 Dec 21.
The effects of estrogen on comprehension of metaphoric speech, word fluency, and verbal ability were investigated in women suffering from schizophrenia. The issue of estrogen-dependent neuropsychological performance could be highly relevant because women with schizophrenia frequently suffer from hypoestrogenism.
A placebo-controlled, double-blind, crossover study using 17beta-estradiol for replacement therapy and as an adjunct to a naturalistic maintenance antipsychotic treatment was carried out over a period of 8 months. Nineteen women (mean age = 38.0 years, SD = 9.9 years) with schizophrenia were included in the study. Comprehension of metaphoric speech was measured by a lexical decision paradigm, word fluency, and verbal ability by a paper-and-pencil test.
Significant improvement was seen for the activation of metaphoric meaning during estrogen treatment (P = .013); in contrast, no difference was found for the activation of concrete meaning under this condition. Verbal ability and word fluency did not improve under estrogen replacement therapy either.
This is the very first study based on estrogen intervention instead of the physiological hormone changes to examine the estrogen effects on neuropsychological performance in women with schizophrenia. In addition, it is the first time that the effect of estrogen on metaphoric speech comprehension was investigated in this context. While in a previous study estrogen therapy as adjunct to a naturalistic maintenance treatment with antipsychotics did not show an effect on psychopathology measured by a rating scale, a significant effect of estrogen on the comprehension of metaphoric speech and/or concretism, a main feature of schizophrenic thought and language disturbance, was found in the present study. Because the improvement of formal thought disorders and language disturbances is crucial for social integration of patients with schizophrenia, the results may have implications for the treatment of these individuals.
研究雌激素对精神分裂症女性隐喻性言语理解、词汇流畅性和语言能力的影响。雌激素依赖性神经心理表现这一问题可能高度相关，因为精神分裂症女性经常患有雌激素缺乏症。
进行了一项为期8个月的安慰剂对照、双盲、交叉研究，使用17β - 雌二醇进行替代疗法，并作为自然维持性抗精神病治疗的辅助药物。19名患有精神分裂症的女性（平均年龄 = 38.0岁，标准差 = 9.9岁）被纳入研究。通过词汇判定范式测量隐喻性言语理解，通过纸笔测试测量词汇流畅性和语言能力。
雌激素治疗期间隐喻意义的激活有显著改善（P = 0.013）；相比之下，在此条件下具体意义的激活未发现差异。雌激素替代疗法下语言能力和词汇流畅性也没有改善。
这是第一项基于雌激素干预而非生理激素变化来研究雌激素对精神分裂症女性神经心理表现影响的研究。此外，这是首次在这种背景下研究雌激素对隐喻性言语理解的影响。虽然在之前的一项研究中，雌激素疗法作为抗精神病药物自然维持治疗的辅助手段，对用评定量表测量的精神病理学没有显示出效果，但在本研究中发现雌激素对隐喻性言语理解和/或具体化（精神分裂症思维和语言障碍的一个主要特征）有显著影响。由于形式思维障碍和语言障碍的改善对精神分裂症患者的社会融入至关重要，这些结果可能对这些个体的治疗有启示意义。
