M27. Peripheral Oxytocin and Vasopressin are Associated With Clinical Symptom Severity and Cognitive Functioning in Midlife Women With Chronic Schizophrenia

Abstract

Abstract Background: Neuroendocrine factors may contribute to the etiology, cognitive and clinical symptom severity, and treatment response in schizophrenia. Very few studies to date focus on midlife women, a subgroup of patients that may be particularly vulnerable to both cognitive and symptom exacerbations as they experience menopause-related hormonal changes. Here we examined the degree to which stress and sex steroid hormones levels are associated with cognitive functioning and clinical symptom severity in midlife women with chronic schizophrenia. Methods: Twenty-six midlife women with schizophrenia/schizoaffective disorder (median age, 42 y; 58% African American) and 20 similarly-matched healthy midlife women were evaluated on clinical symptoms (BPRS, modified SANS, BAI) and completed the RBANS, HVLT-R, and UPSA to assess cognition and everyday functioning. Blood and saliva samples were obtained to assess serum estradiol, oxytocin (OT), and arginine vasopressin (AVP) as well as salivary cortisol levels. Multivariable regression analyses were conducted to examine the contribution of hormones to cognitive functioning and clinical symptom severity after adjusting for age. Menopausal stage was adjusted as needed. Results: Among female patients, lower OT levels were associated with more severe overall clinical symptomatology and positive symptoms on the BPRS (βs = −.61, Ps −.54 Ps −.39, Ps −.70, Ps < .02) and in the domain of visuospatial abilities (β = −.71, P = .03). Higher cortisol levels were associated with better attention (β = .62, P = .02). Conclusion: Menopause-related hormonal changes during midlife appears to contribute to both worse cognitive performance and clinical symptom severity in women with chronic schizophrenia. OT and AVP appear more predictive in female patients whereas estradiol and cortisol appears more predictive in female controls. Larger scale, longitudinal studies are needed to understand the role of neuroendocrine factors in cognitive and clinical symptom severity in schizophrenia as well as across other psychotic disorders where hormonal alterations are common.