Abstract
The theory that many serious mental illnesses, in particular psychoses such as schizophrenia, may have a significant hormonal aetiological component is fast gaining popularity and the support of scientific evidence. Oestrogen in particular has been substantially investigated as a potential mediator of brain function in schizophrenia. Epidemiological and life-cycle data point to significant differences in the incidence and course of schizophrenia between men and women suggests a protective role of oestrogen. In vitro and in vivo preclinical research confirms oestradiol's interactions with central neurotransmitter systems implicated in the pathogenesis of schizophrenia, while results from randomised controlled trials investigating the antipsychotic potential of oestrogen have been positive. Research into other neuroactive hormones with possible effects on mental state is a rapidly evolving field that may hold new promise. Given that schizophrenia and related psychoses are pervasive and debilitating conditions for which currently available treatments are often only partially effective and entail a high risk of serious side-effects, novel therapeutic strategies are needed. The literature reviewed in this paper suggests that hormones such as oestrogen could be a viable option, and it is hoped that with further research and larger trials, the oestrogen hypothesis can be translated into effective clinical practice.
Highlights
Over a century ago, the father of modern psychiatry Emil Kraepelin first implicated an imbalance of sexual hormones in the aetiology of “dementia praecox” [1], and reports of gonadal dysfunction in psychotic patients have been well documented since this time [2]
While the nature of schizophrenia was previously perceived to be similar between men and women [7], it is widely accepted that schizophrenia is a sexually dimorphic disease
It is widely believed that this unique course of illness in older women is related to falling levels of oestrogen during the menopause, the hormone having been protective against psychosis up until this time, that is, the oestrogen protection hypothesis
Summary
The father of modern psychiatry Emil Kraepelin first implicated an imbalance of sexual hormones in the aetiology of “dementia praecox” [1], and reports of gonadal dysfunction in psychotic patients have been well documented since this time [2] It is only with recent scientific advances that the considerable effects of reproductive hormones on central nervous system functioning and mental health have come to light. From the age of 50, her mental state deteriorated significantly and she experienced auditory hallucinations and paranoid delusions She believed that the CIA had implanted a microchip into her brain and that she was under constant surveillance. Miss R’s quality of life suffered greatly She lost her job, was unable to live independently, and financially existed on welfare payments.
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