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Estradiol Production Suppressed by Prolactin in at-risk Mental State and First Episode Psychosis Female Patients? Preliminary Results

Published online by Cambridge University Press:  23 March 2020

S. Ittig ,
E. Studerus ,
U. Heitz ,
S. Menghini-Müller ,
L. Egloff ,
K. Beck ,
L. Leanza ,
C. Andreou  and
A. Riecher-Rössler
E. Studerus
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
U. Heitz
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
S. Menghini-Müller
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
L. Egloff
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
K. Beck
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
L. Leanza
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
C. Andreou
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland
A. Riecher-Rössler
Affiliation:
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland

Abstract

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Introduction

Clinical, epidemiological and basic research studies have confirmed that estradiol can have protective effects in schizophrenic psychoses. At the same time many patients with schizophrenic psychoses – even antipsychotic naïve at-risk mental state (ARMS) patients show hyperprolactinemia and gonadal dysfunction with estrogen deficiency in women and possibly testosterone deficiency in men.

Aim

To investigate the relation between the stress hormone prolactin and the sex hormones estradiol in women and testosterone in men in emerging psychosis.

Methods

Forty-seven antipsychotic-naïve ARMS (38 men and 9 women) and 17 antipsychotic-naive first episode psychosis (FEP) (14 men and 3 women) patients were recruited via the Basel Früherkennung von Psychosen (FePsy) study. Blood was taken under standardized conditions between 8 and 10 am after an overnight fast and 30 minutes of rest. We performed a linear regression model to evaluate the association between prolactin and sex hormones including age and current antidepressant use as covariates.

Results

In women, estradiol was negatively associated with prolactin (β = −1.28, P = 0.01) whereas in men there was a positive association of testosterone with prolactin (β = 0.52, P = 0.031).

Conclusion

The often observed estrogen deficiency in women with psychosis could therefore be explained by the stress hormone prolactin suppressing the gonadal axis already in very early untreated stages of the emerging disease.

In ARMS or FEP men prolactin does not seem to influence the gonadal axis in the same way as in women.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Schizophrenia and other psychotic disorders - Part 3
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S267
Copyright
Copyright © European Psychiatric Association 2017
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