Shahini Najmeh, Salimi Zanireh, Kiani Dorsa, Raftari Ahmad, Ziaee Maliheh
Golestan Research Center of Psychiatry (GRCP), Golestan University of Medical Sciences, Gorgan, Iran.
Clinical Research Development Unit (CRDU), 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran.
Front Psychiatry. 2023 Mar 8;14:1075780. doi: 10.3389/fpsyt.2023.1075780. eCollection 2023.
Schizophrenia is a devastating disease characterized by frequent relapses, cognitive decline, and emotional and functional disability, with unknown causes. The phenomenology and clinical course of schizophrenic disorders are different between the two genders, which is thought to be related mainly to the effects of steroid sex hormones on the nervous system. Regarding inconsistencies in the studies, we aimed to compare the levels of estradiol and progesterone between schizophrenia patients and healthy individuals.
This cross-sectional study was conducted on 66 patients referred to the specialized clinical psychiatric ward of a teaching hospital in the north of Iran, for 5 months in 2021. Thirty-three schizophrenia patients confirmed by a psychiatrist based on DSM5 criteria were included in the case group, and 33 individuals without a psychiatric disease were included in the control group. We completed a demographic information checklist for each patient, along with the Simpson-Angus extrapyramidal side effect scale (SAS) for drug side effects and the positive and negative syndrome scale (PANSS) for the severity of the disease symptoms. Then, a 3-ml blood sample was taken from each participant to determine the serum levels of estradiol and progesterone. The data were analyzed by SPSS16 software.
Thirty-four (51.5%) and 32 (48.5%) participants in this study were male and female, respectively. The mean serum level of estradiol was 22.33 ± 13.65 pm/dl in schizophrenia patients and 29.36 ± 21.32 pm/dl in the control group, showing no significant difference between the two groups ( = 0.4). However, the mean serum level of progesterone was significantly lower in schizophrenia patients (0.37 ± 1.39 pm/dl) than in control subjects (3.15 ± 5.73 pm/dl) ( < 0.001). The PANSS and SAS scores were not significantly correlated with the level of sex hormones ( > 0.05). Serum estradiol and progesterone levels based on sex significantly differed between the two groups (except for female estradiol).
Considering the hormonal differences between schizophrenia patients and control subjects, determining hormonal levels in these patients and using complementary hormonal therapies with estradiol or similar compounds can be beneficial as the starting point of schizophrenia treatment, where therapeutic responses can draw the future developmental framework.
精神分裂症是一种具有破坏性的疾病，其特征为频繁复发、认知衰退以及情感和功能障碍，病因不明。精神分裂症的现象学和临床病程在两性之间存在差异，这被认为主要与甾体性激素对神经系统的影响有关。鉴于研究结果存在不一致性，我们旨在比较精神分裂症患者与健康个体之间的雌二醇和孕酮水平。
这项横断面研究于2021年在伊朗北部一家教学医院的专业临床精神科病房进行了5个月。病例组纳入了33名经精神科医生根据DSM5标准确诊的精神分裂症患者，对照组纳入了33名无精神疾病的个体。我们为每位患者填写了一份人口统计学信息清单，以及用于评估药物副作用的辛普森-安格斯锥体外系副作用量表（SAS）和用于评估疾病症状严重程度的阳性和阴性症状量表（PANSS）。然后，从每位参与者身上采集3毫升血样，以测定血清雌二醇和孕酮水平。数据采用SPSS16软件进行分析。
本研究中分别有34名（51.5%）和32名（48.5%）参与者为男性和女性。精神分裂症患者的血清雌二醇平均水平为22.33±13.65皮摩尔/分升，对照组为29.36±21.32皮摩尔/分升，两组之间无显著差异（P = 0.4）。然而，精神分裂症患者的血清孕酮平均水平（0.37±1.39皮摩尔/分升）显著低于对照组（3.15±5.73皮摩尔/分升）（P < 0.001）。PANSS和SAS评分与性激素水平无显著相关性（P > 0.05）。两组之间基于性别的血清雌二醇和孕酮水平存在显著差异（女性雌二醇除外）。
考虑到精神分裂症患者与对照组之间的激素差异，测定这些患者的激素水平并使用雌二醇或类似化合物的补充激素疗法作为精神分裂症治疗的起点可能是有益的，治疗反应可以为未来的发展框架提供参考。
