Exploring a Possible Interplay between Schizophrenia, Oxytocin, and Estrogens: A Narrative Review

Papadea, Danae; Dalla, Christina; Tata, Despina Α.

doi:10.3390/brainsci13030461

Cited by 6 publications

(6 citation statements)

References 137 publications

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“…The fifth and most recent hypothesis suggests a reduction in levels of oxytocin, in comparison to normal values in women with PPD, which was based on previous evidence from non-perinatal samples (29,30). Only one study (26) met the criteria in our search.…”

Section: Two Hypothesesmentioning

confidence: 99%

“…Only one study (26) met the criteria in our search. A non-perinatal study (29) found low levels of oxytocin in patients with a first psychotic episode, highlighting that increasing it can lessen alterations of mood and social cognition. Another study (30) reported that during menopause, lower levels of oxytocin in women with schizophrenia are associated with more severe psychiatric symptoms.…”

Section: Two Hypothesesmentioning

confidence: 99%

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Hormones, psychotic disorders, and cognition in perinatal women: a mini review

Palacios-Hernández,

Ramírez-Alvarado,

Téllez-Alanís

et al. 2024

Front. Psychiatry

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Previous scientific evidence has shown a relationship between hormones and the onset and relapse of perinatal psychotic disorders (PPD) in women during pregnancy, childbirth, and the postpartum period. In healthy women the interaction between hormones and cognitive changes has been confirmed mainly in memory, attention, and executive function during pregnancy and postpartum, which respond to adaptive demands related to parenting tasks. In women with psychotic episodes there is a significant impairment in several cognitive functions, but studies of the perinatal period are limited. The objective of this mini review is to analyze the main findings to identify whether hormonal changes interact with the onset of PPD and cognitive impairment in perinatal women. The studies included samples of women with psychosis, risk of developing psychosis, bipolar psychosis, schizoaffective psychosis, and psychotic symptoms, during pregnancy and postpartum. Findings contributed to knowledge about five hypotheses regarding the relationship between hormones in the perinatal period and the appearance of PPD. Nevertheless, this review did not find reports of evidence of a relationship between hormonal production and cognitive function among women with clinically diagnosed PPD, suggesting a research gap. Clinical implications of assessing hormonal production and cognitive function in PPD are discussed. Although the evidence identified is scarce and heterogeneous, the findings call for further research with clinical samples on the role of hormones in perinatal psychotic disorders, especially as they relate to the study of cognition. This will promote more consistent evidence and understanding of PPD etiopathology that can guide early and effective multidisciplinary interventions.

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Section: Two Hypothesesmentioning

confidence: 99%

Section: Two Hypothesesmentioning

confidence: 99%

Hormones, psychotic disorders, and cognition in perinatal women: a mini review

Palacios-Hernández,

Ramírez-Alvarado,

Téllez-Alanís

et al. 2024

Front. Psychiatry

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“…A recent hypothesis regarding schizophrenia suggested that insufficient estrogen and oxytocin levels are upstream etiologies. Moderate increases in these hormones ameliorate the positive and negative symptoms of schizophrenia by attenuating impairments in prepulse inhibition, resulting in the facilitation of emotion recognition and social interaction ( 34 ).…”

Section: Introductionmentioning

confidence: 99%

Giftedness and atypical sexual differentiation: enhanced perceptual functioning through estrogen deficiency instead of androgen excess

Sakaguchi,

Tawata

2024

Front. Endocrinol.

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Syndromic autism spectrum conditions (ASC), such as Klinefelter syndrome, also manifest hypogonadism. Compared to the popular Extreme Male Brain theory, the Enhanced Perceptual Functioning model explains the connection between ASC, savant traits, and giftedness more seamlessly, and their co-emergence with atypical sexual differentiation. Overexcitability of primary sensory inputs generates a relative enhancement of local to global processing of stimuli, hindering the abstraction of communication signals, in contrast to the extraordinary local information processing skills in some individuals. Weaker inhibitory function through gamma-aminobutyric acid type A (GABAA) receptors and the atypicality of synapse formation lead to this difference, and the formation of unique neural circuits that process external information. Additionally, deficiency in monitoring inner sensory information leads to alexithymia (inability to distinguish one’s own emotions), which can be caused by hypoactivity of estrogen and oxytocin in the interoceptive neural circuits, comprising the anterior insular and cingulate gyri. These areas are also part of the Salience Network, which switches between the Central Executive Network for external tasks and the Default Mode Network for self-referential mind wandering. Exploring the possibility that estrogen deficiency since early development interrupts GABA shift, causing sensory processing atypicality, it helps to evaluate the co-occurrence of ASC with attention deficit hyperactivity disorder, dyslexia, and schizophrenia based on phenotypic and physiological bases. It also provides clues for understanding the common underpinnings of these neurodevelopmental disorders and gifted populations.

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“…Research suggests that mentalization is linked with specific brain structures and networks, notably the right temporoparietal junction, the right middle temporal gyrus, and the left precuneus [ 29 ]. It has also been hypothesized that there is a reciprocity between sex hormones and social cognition in schizophrenia, where oxytocin, estrogens, and testosterone could have a role [ 30 ], and being exposed to these in fetal life might have an effect on the disorder [ 31 ]. An expanding body of literature has documented various deficits in both cognitive and affective facets of mentalizing in individuals diagnosed with psychosis, and the anomalies within this specific metacognitive domain are responsible for a significant portion of the compromised social functioning and poor social outcomes observed [ 32 , 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring Personal Recovery in Schizophrenia: The Role of Mentalization

Concerto,

Rodolico,

Mineo

et al. 2023

JCM

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Recovery is a broadly debated concept in the field of psychiatry research and in schizophrenia. Our study aims to understand the correlation between personal recovery from schizophrenia and factors such as mentalization, disability, quality of life, and antipsychotic side effects; Methods: Participants with schizophrenia (according to DSM-5 criteria) were consecutively recruited from the Psychiatry Unit of the University of Catania, Italy. Participants were assessed with the Recovery Assessment Scale (RAS), the Multidimensional Mentalizing Questionnaire (MMQ), the brief version of the WHO Disability Assessment Schedule (WHO-DAS), the EuroQoL-5 dimensions-5 levels, the Insight Orientation Scale (IOS) and the Glasgow Antipsychotic Side Effect Scale (GASS); Results: 81 patients were included. Our findings showed a positive correlation between RAS total scores and MMQ scores, especially in “good mentalizing” subdomains. IOS scores also had a positive association with RAS and MMQ scores. In contrast, poor mentalizing abilities negatively correlated with WHO-DAS 2.0 scores. While antipsychotic side effects influenced functioning, they did not impact perceived recovery. Conclusions: The study’s results identified potential predictors of personal recovery from schizophrenia. These findings could contribute to creating tailored interventions to facilitate the recovery process.

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Exploring a Possible Interplay between Schizophrenia, Oxytocin, and Estrogens: A Narrative Review

Cited by 6 publications

References 137 publications

Hormones, psychotic disorders, and cognition in perinatal women: a mini review

Hormones, psychotic disorders, and cognition in perinatal women: a mini review

Giftedness and atypical sexual differentiation: enhanced perceptual functioning through estrogen deficiency instead of androgen excess

Exploring Personal Recovery in Schizophrenia: The Role of Mentalization

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