From the Journals

Schizophrenia and gender: Do neurosteroids account for differences?



Neurosteroids may be tied to the gender differences found in the susceptibility to schizophrenia, a cross-sectional, case control study showed.

“These findings suggest that neurosteroids are involved in the pathophysiology of schizophrenia in male patients but not so much in female patients,” reported Yu-Chi Huang, MD, of the department of psychiatry at Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan, and associates.

To conduct the study, the researchers recruited 65 patients with schizophrenia from an outpatient department and psychiatry ward of the hospital. Eligible patients were aged 18-65 years, diagnosed with schizophrenia as defined by the DSM-IV-TR, and taking a stable dose of antipsychotics for at least 1 month before the start of the study. In addition, the participants could have no history of major physical illnesses and had to be of ethnic Han Chinese origin. Thirty-six of the patients were men.

The control group was made up of 103 healthy hospital staff and community members who were within the same age range as the patients. The controls could have no history of illicit drug use, physical illnesses, or psychiatric disorders and had to be ethnic Han Chinese. Forty-seven members of the control group were males (Psychoneuroendocrinology. 2017 Oct;84:87-93).

Participants fasted and blood samples were obtained. Dehydroepiandrosterone (DHEA) levels were measured using the DHEA ELISA [enyme-linked immunosorbent assay] – ADKI-900-093, dehydroepiandrosterone sulfate (DHEAS) levels were measured with the Architect DHEA-S reagent kit, and pregnenolone levels were measured using the pregnenolone ELISA kit. Psychiatric diagnoses were assessed for both groups using a psychiatric interview based on the Mini-International Neuropsychiatric Interview, the Positive and Negative Syndrome Scale (PANSS), and the 17-item Hamilton Depression Rating Scale. Several factors tied to schizophrenia were evaluated, including the age of onset, illness duration, and use of antipsychotics. The numbers were placed into a database and analyzed.

After controlling for age and body mass index, the researchers found that in male patients with schizophrenia, DHEA and DHEAS serum levels were positively associated with the age of onset of schizophrenia (P less than .05) and negatively associated with the duration of illness (P less than .05). In addition, they found that pregnenolone levels were associated positively with general symptoms of the PANSS in the male schizophrenia patients (P less than .05 ). Furthermore, the levels of DHEA, DHEAS, and pregnenolone were lower among the male schizophrenia patients, compared with the serum levels of the healthy male controls. No differences were found in serum levels among the female patients with schizophrenia and the healthy controls.

The findings suggest that DHEA, DHEAS, and pregnenolone could be markers of the duration of illness and the severity of general symptoms among male patients with schizophrenia. To read the entire study, click here.

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