Doğan Bulut Süheyla, Bulut Serdar, Güriz Olga
Psychiatry Department, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, İrfan Baştuğ cad. no.12 Dışkapı-Altındağ, Ankara 06110, Turkey.
Psychiatry Department, Yenimahalle Teaching and Research Hospital, Yeni Batı mah. 2026 cad. 2367 sok. no.4 Batıkent, Ankara 06370, Turkey.
Compr Psychiatry. 2016 Aug;69:186-92. doi: 10.1016/j.comppsych.2016.06.005. Epub 2016 Jun 13.
Recent studies have shown that sex hormones play a role in the development of schizophrenia and the severity of disease symptoms. However, study results have been inconsistent. This study compares the relationship between severity of disease symptoms and levels of estradiol, progesterone, testosterone, DHEA-S, prolactin and cortisol in male schizophrenia patients and a matched group of healthy controls.
The study sample included 38 men diagnosed with schizophrenia according to DSM-IV TR criteria, and matched by age with 38 healthy controls. All subjects were between 18 and 55years old, 22 of them had been treated with olanzapine and 16 with quetiapine. Their symptom severity was evaluated by administering the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). Hormone levels for schizophrenia patients and healthy controls were evaluated using a chemiluminescence immunoassay method. The hormone profiles of schizophrenia patients and healthy controls were compared statistically. We examined the relationship between subjects' and controls' hormone levels and their scores on the SANS and SAPS scales.
This study found statistically significant elevated levels of serum DHEA-S, cortisol, and prolactin (p=0.012, p=0.009, and p=0.021 respectively), in schizophrenia patients as compared to a control group. Subjects' serum estradiol and progesterone levels (p=0.005 and p<0.001 respectively), were significantly lower than controls' levels. There was a positive correlation between subjects' SANS scores, estradiol (p=0.001) and progesterone levels (p=0.027). No relationship was found between subjects' hormone levels and their SAPS scores.
There may be a relationship between progesterone, estradiol, cortisol and DHEA-S, and the pathophysiology of schizophrenia. These hormones can be used as biological markers for the disorder of schizophrenia. More studies with larger sample sizes are needed to confirm these findings.
近期研究表明,性激素在精神分裂症的发病及疾病症状严重程度方面发挥作用。然而,研究结果并不一致。本研究比较了男性精神分裂症患者与相匹配的健康对照组中疾病症状严重程度与雌二醇、孕酮、睾酮、硫酸脱氢表雄酮(DHEA-S)、催乳素及皮质醇水平之间的关系。
研究样本包括38名根据《精神疾病诊断与统计手册》第四版修订版(DSM-IV TR)标准诊断为精神分裂症的男性,以及38名年龄匹配的健康对照。所有受试者年龄在18至55岁之间,其中22人接受过奥氮平治疗,16人接受过喹硫平治疗。通过使用阳性症状评定量表(SAPS)和阴性症状评定量表(SANS)评估其症状严重程度。采用化学发光免疫分析法评估精神分裂症患者和健康对照的激素水平。对精神分裂症患者和健康对照的激素谱进行统计学比较。我们研究了受试者及对照的激素水平与他们在SANS和SAPS量表上得分之间的关系。
本研究发现,与对照组相比,精神分裂症患者血清DHEA-S、皮质醇和催乳素水平在统计学上显著升高(分别为p = 0.012、p = 0.009和p = 0.021)。受试者的血清雌二醇和孕酮水平(分别为p = 0.005和p < 0.001)显著低于对照组水平。受试者的SANS得分与雌二醇(p = 0.001)和孕酮水平(p = 0.027)之间存在正相关。未发现受试者的激素水平与他们的SAPS得分之间存在关联。
孕酮、雌二醇、皮质醇和DHEA-S与精神分裂症的病理生理学之间可能存在关联。这些激素可作为精神分裂症紊乱的生物学标志物。需要更多大样本量的研究来证实这些发现。