Abstract
IntroductionSchizophrenia is a chronic disease that significantly impacts cognitive functioning. Sex differences in incidence, onset and course of schizophrenia suggest estrogens have a protective role.ObjectivesOur aim is to review the state of the art on this matter.MethodsThrough a selection of the most relevant articles found on PubMed and ClinicalKey searching the keywords: “estrogens” and “schizophrenia”.Results Accumulating evidence has led to the hypothesis that estrogens act as a protective factor in women regarding the onset of schizophrenia as their increase in puberty may help delay the onset of symptoms. Also, the estrogens abrupt decline in menopause may account for a second peak of onset and greater severity of the symptoms. During the menstrual cycle, when serum estrogens are at their lowest, there is an increase in the number of psychotic episodes and an exacerbation of psychotic symptoms. Pregnancy leads to an improvement of psychotic symptoms, which then worsen in postpartum. Clinical trials testing the efficacy of estrogens have been promising, which suggest they might be a useful adjuvant treatment. Despite the evidence of clinical efficacy, health risks for women using estrogen therapy should be considered, as they decrease its acceptability as a viable treatment option. The use of selective estrogen receptor modulators (SERMs), as raloxifene, could be a favorable and safer alternative.ConclusionsIn conclusion, estrogens are proving to be a promising option as a complementary therapy for schizophrenia; however, further studies are needed to investigate whether they might be overall beneficial.DisclosureNo significant relationships.
Highlights
Cerebral abscesses are rare, occurring in approximately 0.3–1 per 100 000 patients
Hereby we present a clinical case of a 53-year-old female patient, with multiple sclerosis, who presented with hypochondriac and nihilistic delusions and refusal of food and medication
While various neurological disorders have been described in association with Cotard syndrome, its link with multiple sclerosis has been scarcely reported
Summary
In literature it has been divided into three types, according to the clinical symptoms: psychotic depression, Cotard type I, and Cotard type II. Objectives: Literature review on Cotard Syndrome and its link with Multiple Sclerosis, based on a clinical case. Methods: Pubmed and Google Scholar search using the keywords Cotard Syndrome, Multiple Sclerosis. Results: Hereby we present a clinical case of a 53-year-old female patient, with multiple sclerosis, who presented with hypochondriac and nihilistic delusions and refusal of food and medication. While various neurological disorders have been described in association with Cotard syndrome, its link with multiple sclerosis has been scarcely reported. Management challenges in a schizophrenic patient with multiple brain abscesses: A case report.
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