The Monash Alfred Psychiatry Research Centre, The Alfred and Monash University School of Psychology, Psychiatry and Psychological Medicine, Melbourne, Victoria, Australia.
Curr Opin Psychiatry. 2012 Mar;25(2):89-95. doi: 10.1097/YCO.0b013e328350360e.
It is a well established fact that many serious mental illnesses, in particular psychoses such as schizophrenia, may have a significant hormonal aetiological component. This study aims to discuss the oestrogen protection hypothesis of schizophrenia in particular, with an emphasis on findings from the recent literature in support of this theory.
Epidemiological and life-cycle data point to significant differences in the incidence and course of schizophrenia between men and women, suggesting a protective role of oestrogen. In-vitro and in-vivo preclinical research has confirmed oestradiol's interactions with central neurotransmitter systems implicated in the pathogenesis of schizophrenia, whereas results from randomized controlled trials investigating the antipsychotic potential of oestrogen have been promising. Research into other neuroactive hormones with possible effects on mental state is a field still in its infancy but is evolving rapidly.
Schizophrenia and related psychoses are pervasive and debilitating conditions, for which currently available treatments are often only partially effective and entail a high risk of serious side effects. Thus, new therapeutic strategies are needed, and the literature reviewed here suggests that hormones such as oestrogen could be a viable option. It is hoped that, with further research and larger trials, the oestrogen hypothesis can be translated into effective clinical practice.
许多严重的精神疾病,特别是精神分裂症等精神病,可能有重要的激素病因学成分,这是一个既定事实。本研究旨在特别讨论精神分裂症的雌激素保护假说,重点是最近支持这一理论的文献研究结果。
流行病学和生命周期数据表明,男性和女性精神分裂症的发病率和病程存在显著差异,表明雌激素有保护作用。体外和体内临床前研究证实了雌二醇与精神分裂症发病机制中涉及的中枢神经递质系统的相互作用,而雌激素抗精神病作用的随机对照试验结果令人鼓舞。其他可能影响精神状态的神经活性激素的研究仍处于起步阶段,但发展迅速。
精神分裂症和相关精神病是普遍存在且使人衰弱的疾病,目前可用的治疗方法往往仅部分有效,并伴有严重副作用的高风险。因此,需要新的治疗策略,这里综述的文献表明,雌激素等激素可能是一种可行的选择。希望随着进一步的研究和更大规模的试验,雌激素假说能够转化为有效的临床实践。