Riecher-Rössler A, Häfner H
Central Institute of Mental Health, Mannheim, Germany.
Eur Arch Psychiatry Clin Neurosci. 1993;242(6):323-8. doi: 10.1007/BF02190244.
Some early psychiatrists already believed that schizophrenic disorders were associated with a disturbed balance of sexual hormones. This belief was based on the observation of a. an "insufficient functioning of the sexual glands" with so-called "hypoestrogenism", and b. an influence of ovarian function on schizophrenic psychoses. As this review shows, there are findings from recent research which seem to confirm that estrogens may have a protective effect in schizophrenia. There are also occasional hints at a possible "hypoestrogenism" in schizophrenia. In our own epidemiological, clinical and animal studies the hypothesis of a protective effect of oestrogens was for the first time systematically examined and confirmed. Oestrogens seem to modulate the sensitivity of D2-receptors in the brain, and clinically they seem to have a neuroleptic-like effect. These findings may have important implications for the prevention and therapy of schizophrenic disorders. Furthermore, our findings indicate the need to reinvestigate the question of a disturbed balance of sexual hormones in schizophrenic disorders. Further research on the role of oestrogens in schizophrenic disorders could in our opinion contribute to understanding the still unclear, possibly aetiologically heterogeneous pathogenetic mechanism of schizophrenic psychoses.
一些早期的精神病学家已经认为精神分裂症与性激素平衡紊乱有关。这种观点基于以下观察结果:a. 性腺功能“不足”以及所谓的“雌激素缺乏”;b. 卵巢功能对精神分裂症性精神病的影响。正如本综述所示,近期研究的一些发现似乎证实雌激素可能对精神分裂症具有保护作用。也偶尔有迹象表明精神分裂症患者可能存在“雌激素缺乏”。在我们自己的流行病学、临床及动物研究中,首次对雌激素具有保护作用这一假说进行了系统研究并得到证实。雌激素似乎可调节大脑中D2受体的敏感性,在临床上它们似乎具有类似抗精神病药物的作用。这些发现可能对精神分裂症的预防和治疗具有重要意义。此外,我们的研究结果表明有必要重新审视精神分裂症中性激素平衡紊乱的问题。我们认为,进一步研究雌激素在精神分裂症中的作用有助于理解精神分裂症性精神病尚不明确、可能病因异质性的发病机制。