A Study of the Histology of the Testis in Schizophrenia and other Mental Disorders

Abstract

Histological examinations were made of biopsy specimens from the testes of 90 cases of schizophrenia and 25 cases of other mental disorders. Pathological changes of varying severity were observed in many specimens ; these changes have been classified in grades according to the intensity of the degenerative process. The non-schizophrenic specimens were within normal limits, due allowance being made for age and organic disease. A special form of atrophy involving chiefly the tubules and their contents was found in many cases of schizophrenia, but not in other mental disorders. This atrophy is characterized by changes in the basement membrane leading to its hyalinization, with arrest of spermatogenesis, progressive degeneration of epithelial elements, and eventual destruction of the tubule. The course and development of this atrophy have been described and analysed. It differs in essential features from atrophy due to systemic affections and to the familiar causes of testis degeneration. Interstitial hyperplasia is rare, and when present in schizophrenic subjects is due to some superimposed organic process. The work of Mott and others has been discussed in the light of this study. Although they reported pathological changes which they regarded as specific for schizophrenia (dementia praecox), the histology differed significantly from what is described in this paper. It is clear that as autopsy was the only source of their material, serious contaminating factors, such as advanced age and intercurrent infections, were introduced, and would inevitably tend to obscure the histological picture. The importance of a normal basement membrane for preservation of Sertoli cells and seminiferous epithelium has been demonstrated, and it has been shown that hyaline change in the basement membrane in atrophy of the testis is a cause and not a result of degeneration of the epithelium as other writers have suggested.