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Schizophrenia and oestrogens — is there an association?

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Summary

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.

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References

  • Baruk H, Melzer R, Vezous A, Farjeat J (1950) L'effondrement oestrogénique dans la démence precoce. Etude par la méthode des frottis vaginaux de Papanicolaou. Ann of Medical Psychol (Paris) 108:181–187

    Google Scholar 

  • Bédard P, Langelier P, Villeneuve A (1977) Estrogens and the Extrapyramidal System. Lancet II:1367–1368

    Article  Google Scholar 

  • Bédard P, Boucher R, Daigle M, DiPaolo T (1984) Similar effect of estradiol and haloperidol on experimental tardive dyskinesia in monkeys. Psychoneuroendocrinology 9:375–379

    Article  PubMed  Google Scholar 

  • Beumont PJ, Gelder MG, Friesen HG, Harris GW, McKinnon PC, Mandelbrote BM, Wiles DH (1974) The effects of phenothiazines on endocrine function: Patients with inappropriaqte lactation and amenorrhea. Br J Psychiatry 124:413–419

    PubMed  Google Scholar 

  • Bleuler M (1943) Die spätschizophrenen Krankheitsbilder. Neurologie XV, 9:259–290

    Google Scholar 

  • Brambilla F, Guerrini A, Guastalla A, Rovere C, Riggi F (1975) Neuroendocrine Effect of Haloperidol Therapy in Chronic Schizophrenia. Psychopharmacologia 44:17–22

    Article  PubMed  Google Scholar 

  • Brambilla F (1980) Neuroendocrine function in schizophrenia. Acta Psychiatria Belg 80:421

    Google Scholar 

  • Carlsson A (1987) The dopamine hypothesis of schizophrenia 20 years later. In: Häfner H; Gattaz WF; and Janzarik W (eds) Search for the causes of schizophrenia. Springer, Berlin Heidelberg New York, pp 223–235

    Google Scholar 

  • Chang SS, Renshaw DC (1986) Psychosis and pregnancy. Compr Ther 12:36–41

    Google Scholar 

  • Collu R, Jequier JC, Leboeuf J, Ducharme JR (1977) Endocrine effects of pimozide, a specific dopaminergic blocker. J Endocrinol Metab 44:981–948

    Google Scholar 

  • Cookson JC (1981) Oestrogens, dopamine and mood. Br J Psychiatry 139:365

    PubMed  Google Scholar 

  • Czernik A, Kleesiek K (1979) Die Wirkung von Depotneuroleptika auf die Hormonsekretion des Hypophysen-Vorderlappens. Nervenarzt 50:527–533

    PubMed  Google Scholar 

  • Diczfalusy E, Lauritzen C (1961) Östrogene beim Menschen. Springer, Berlin Göttingen Heidelberg

    Google Scholar 

  • Diedrich K, Wildt L (1990) Neue Wege in Diagnostik und Therapie der Sterilität. Enke, Stuttgart

    Google Scholar 

  • DiPaolo T, Payet P, Labrie F (1981) Effect of chronic estradiol and haloperidol treatment on striatal dopamine receptors. Eur J Pharmacol 73:105–106

    Article  PubMed  Google Scholar 

  • Dupont A, DiPaolo T, Gagne B, Barden N (1981) Effects of chronic estrogen treatment on dopamine concentrations and turnover in discrete brain nuclei of ovariectomized rats. Neurosci Let 22:69–74

    Article  Google Scholar 

  • Endo M, Daiguji M, Asano Y, Yamashita I, Takahashi S (1978) Periodic Psychosis recurring in Association with Menstrual Cycle. J Clin Psychiatry 39:456–466

    PubMed  Google Scholar 

  • Ferrier IN, Johnstone EC, Crow TJ, Rinzcon-Rodriguez I (1983) Anterior pituitary hormone secretion in chronic schizophrenics: responses to administration of hypothalamic releasing hormones. Arch Gen Psychiatry 40:755

    PubMed  Google Scholar 

  • Foreman MM, Porter JC (1980) Effects of catechol estrogens and catecholamines on hypothalamic and corpus striatal tyrosine hydroxylase activity. J Neurochem 34:1175–1183

    PubMed  Google Scholar 

  • Gattaz WF, Behrens S, De Vry J, Häfner H (1991) Östradiol hemmt Dopamin-vermittelte Verhaltensweisen bei Ratten: ein Tiermodell zur Untersuchung der geschlechtsspezifischen Unterschiede bei der Schizophrenie. Fortschr Neurol Psychiatr 1:1–44

    Google Scholar 

  • Geller EC (1923) Über Eierstocksfunktion bei Dementia praecox auf Grund anatomischer Untersuchungen. Arch Gynae 120:237

    Article  Google Scholar 

  • Glick J, Stewart D (1980) A new drug treatment for premenstrual exacerbation of schizophrenia. Compr Psychiatry 21:281–287

    Article  PubMed  Google Scholar 

  • Goldstein MJ, Rodnick FH, Evans JR, May PRA, Steinberg MR (1978) Drugs and family therapy in the aftercare of acute schizophrenics. Arch Gen Psychiatry 35:1169–1177

    PubMed  Google Scholar 

  • Gordon JH, Diamond BI (1981) Antagonism of dopamine supersensivity by estrogen: neurochemical studies in an animal model of tardive dyskinesia. Biol Psychiatry 16:365–371

    PubMed  Google Scholar 

  • Gordon JH, Borison RL, Diamond BI (1980) Modulation of dopamine receptor sensitivity by estrogen. Biol Psychiatry 15:389–396

    PubMed  Google Scholar 

  • Häfner H (1987) Epidemiology of Schizophrenia. In: Häfner H, Gattaz WF, Janzarik W (eds) Search for the causes of schizophrenia, vol I. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Häfner H, Riecher A, Maurer K, Löffler W, Munk-Jørgensen P, Strömgren E (1989) How does gender influence age at first hospitalization for schizophrenia? Psychol Med 19:903–918

    PubMed  Google Scholar 

  • Häfner H, Behrens S, De Vry J, Gattaz WF, Löffler W, Maurer K, Riecher-Rössler A (1991a) Warum erkranken Frauen später an Schizophrenie? Erhöhung der Vulnerabilitätsschwelle durch Östrogen. Nervenheilk 10:154–163

    Google Scholar 

  • Häfner H, Behrens S, De Vry J, Gattaz WF (1991b) An animal model for the effects of estradiol on dopamine-mediated behaviour: implications for sex differences in schizophrenia. Psychiatry Res 38:125–134

    Article  PubMed  Google Scholar 

  • Häfner H, Riecher-Rössler A, Hambrecht M, Maurer K, Meissner S, Schmidtke A, Fätkenheuer B, Löffler W, Heiden W an der (1991c) Geschlechtsunterschiede bei schizophrenen Erkrankungen. Fortsch Neurol Psychiatr 59:343–360

    Google Scholar 

  • Hogarty GE, Goldberg SC, Schooler NR, Ulrich RF (1974) Drug and sociotherapy in the aftercare of schizophrenic patients. Arch Gen Psychiatry 31:603–618

    PubMed  Google Scholar 

  • Holsboer F, Benkert O, Demisch L (1983) Changes in MAO activity during estrogen treatment of females with endogenous depression. Mod Probl Pharmacopsychiatry 19:321–326

    PubMed  Google Scholar 

  • Hruska RE, Silbergeld EK (1980) Estrogen treatment enhances dopamine receptor sensitivity in the rat striatum. Eur J Pharmacol 61:397–400

    Article  PubMed  Google Scholar 

  • Kane JM, Cooper TB, Sachar EJ, Halpern FS, Bailine S (1981) Clozapine: plasma levels and prolactin response. Psychopharmacology 73:184

    Article  PubMed  Google Scholar 

  • Kendell RE, Chalmers JC, Platz C (1987) Epidemiology of puerperal psychoses. Br J Psychiatry 150:662–673

    PubMed  Google Scholar 

  • Koller WC, Weiner WJ, Klawans HL, Nausieda PA (1980) Influence of female sex hormones on neuroleptic-induced behavioral supersensitivity. Neuropharmacology 19:387–391

    Article  PubMed  Google Scholar 

  • Kraepelin E. (1909–1915) Psychiatrie, Bd 1–4. Barth, Leipzig

    Google Scholar 

  • Krafft-Ebing G von (1896) Untersuchungen über Irresein zur Zeit der Menstruation: Ein klinischer Beitrag zur Lehre vom periodischen Irresein. Arch Psychiatr 8:65–107

    Article  Google Scholar 

  • Kretschmer E (1921) Körperbau und Charakter. Untersuchungen zum Konstitutionsproblem und zur Lehre von den Temperamenten. 25th edition 1967. Springer, Berlin Heidelberg New York

    Google Scholar 

  • Lewine RRJ (1988) Gender and Schizophrenia. In: Nashrallah HA (ed) Handbook of schizophrenia, vol 3. Elsevier, New York, pp 121–136

    Google Scholar 

  • Lobo RA, Shoupe D, Roy S, Paul W (1984) Central and peripheral metabolites of norepinephrine and dopamine in postmenopausal women. Am J Obstet Gynecol 5:548–552

    Google Scholar 

  • Maggi A, Perez J (1985) Minireview: role of female gonodal hormones in the CNS; clinical and experimental aspects. Life Sci 37:893–906

    Article  PubMed  Google Scholar 

  • Mall G (1959) Neuere Ergebnisse der Psycho-Endokrinologie. Ärztl Prax XI/40:1357–1360

    Google Scholar 

  • Mall G (1960) Diagnostik und Therapie ovarieller Psychosen. Zentralbl Gesamte Neurol Psychiatr 155:250

    Google Scholar 

  • Naber D, Ackenheil M, Laakman G, Fischer H, von Werder K (1980) Basal and stimulated levels of prolactin, TSH and LH in serum of chronic schizophrenic patients, long-term treated with neuroleptics. Pharmakopsychiatry 13:325–330

    Google Scholar 

  • Nicoletti F, Ferrara N, Patti F, Viglianesi M, Rampello L, Bianchi A, Reggio A, Scapagnini U (1983) Influence of sex steroids and prolactin on haloperidol-induced catalepsy. Brain Res 279:352–358

    Article  PubMed  Google Scholar 

  • Nott PN (1982) Psychiatric illness following childbirth in Southampton: A case register study. Psychological Med 12:557–561

    Google Scholar 

  • Prentice DS, Deakin JFW (1992) Role of neuroleptic drugs and organic mechanism in the aetiology of menstrual irregularities in women. Schizophr Res 6(2):114

    Article  Google Scholar 

  • Riecher A, Maurer K, Löffler W, Fätkenheuer B, an der Heiden W, Häfner H (1989) Schizophrenia — a Disease of Young Single Males? Eur Arch Psychiatry Neuroll Sci 239:210–212

    Article  Google Scholar 

  • Riecher A, Maurer K, Löffler W, Fätkenheuer B, an der Heiden W, Munk-Jørgensen P, Strömgren E, Häfner H (1991) Sex differences in age at onset and course of schizophrenic disorders — a contribution to the understanding of the disease? In: Häfner H, Gattaz WF (eds) Search for the causes of schizophrenia, vol 2. Springer, Berlin Heidelberg New York, pp 14–33

    Google Scholar 

  • Riecher-Rössler A, Häfner H, Stummbaum M, Maurer K, Schmidt R (1993) Can estradiol modulate schizophrenic symptomatology? Schizophrenia Bull (in press)

  • Seeman MV (1981) Gender and the Onset of Schizophrenia: Neurohumoral Influences. Psychiatr J Univ Ottawa 6:136–138

    Google Scholar 

  • Seeman MV (1983) Interaction of sex, age, and neuroleptic dose. Compr Psychiatry 24:125–128

    Article  PubMed  Google Scholar 

  • Seeman MV, Lang M (1990) The role of estrogens in schizophrenia gender differences. Schizophrenia Bull 16:185–194

    PubMed  Google Scholar 

  • Villeneuve A, Cazejust T, Cote M (1980) Estrogens in tardive dyskinesia in male psychiatric patients. Neuropsychobiology 6:145–151

    PubMed  Google Scholar 

  • Wieck A (1989) Endocrine aspects of postnatal mental disorders. Baillière's Clinical Obstetrics and Gynaecology 3:857–877

    Google Scholar 

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Riecher-Rössler, A., Häfner, H. Schizophrenia and oestrogens — is there an association?. Eur Arch Psychiatry Clin Nuerosci 242, 323–328 (1993). https://doi.org/10.1007/BF02190244

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