Variation in symptom severity over the menstrual cycle of Schizophrenics

Hallonquist, John D.; Seeman, Mary V.; Lang, M.; Rector, Neil A.

doi:10.1016/0006-3223(93)90141-y

Cited by 134 publications

(65 citation statements)

References 10 publications

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“…From this we concluded that oestrogen also has a weak neuroleptic-like effect on schizophrenic symptoms. An analogous variation in symptom severity over the menstrual cycle was also reported by Hallonquist et al (1993), and similar clinical observations had previously been published by Dalton (1959) and Endo et al (1978). Seeman and Cohen (1999), early proponents of the oestrogen hypothesis, tested the hypothesis that an earlier onset of functional oestrogen secretion with puberty might be associated with a later onset of schizophrenia in women.…”

Section: Testing the Oestrogen Hypothesis At Different Levels (Domain 5)supporting

confidence: 73%

Schizophrenia: do men and women suffer from the same disease?

Häfner¹

2002

Rev. psiquiatr. clín.

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This article reviews the literature on normal brain development and behavioural development in men and women as well as on aetiological risk factors for schizophrenia, such as pre-, peri-and postnatal complications.The male-female comparisons of age and type of onset, symptomatology, course and outcome were based on a population-based sample of 232 first illness episodes -the ABC Schizophrenia Study sample. The probands were assessed using the IRAOS interview and other instruments retrospectively at first admission and prospectively at six cross sections over five years after first contact. A representative subsample of 130 first admissions or 115 first illness episodes were compared with 130 controls, matched by age, sex and area of residence.Women, 3 to 4 years older than men at illness onset, showed a second peak of onsets in age group 45 to 50 years. After animal experiments and a controlled clinical study this finding was explained by a protective effect of oestrogen persisting until menopause. The underlying neurobiological mechanism consisted in a sensitivity reducing effect of oestrogen on D2 receptors in the brain. The effect of oestrogen, meanwhile confirmed in randomised control trials, also includes genomic effects as well as interactions with free-radical detoxifying systems, thus demonstrating the neuroprotective capabilities of oestrogen.Postmenopausal schizophrenia was more frequent and more severe in women. Men fell ill more frequently and more severely at young age and less frequently and more mildly later in life. Illness course, too, was more unfavourable in postmenopausal women than in their male peers.The protective effect of oestrogen in women depended on the degree of their predisposition to the illness: the higher the familial load for schizophrenia, the weaker the protection by oestrogen. The more favourable illness course in premenopausal women resulted from their higher level of social development at illness onset -determined by their higher age at onset -and from their socially more adaptive behaviour. The illness behaviour of young men showed a significant excess of socially negative behaviours with an unfavourable impact on their early illness course. In contrast, older men were socially better adjusted. With genetic and morphological findings considered the subtypes of schizophrenia did not differ between men and women.Gender differences in symptomatology and course of schizophrenia obviously are not explained by differences in the disease process. They seem to be determined by a complex pattern of interaction between disease variables, hormonal and behavioural differences and their consequences for age at onset and illness course.

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Section: Testing the Oestrogen Hypothesis At Different Levels (Domain 5)supporting

confidence: 73%

Schizophrenia: do men and women suffer from the same disease?

Häfner¹

2002

Rev. psiquiatr. clín.

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“…For example, a later age of onset of symptoms related to schizophrenia is observed in women (Aleman et al, 2003) and women generally respond to lower doses of medications that target D2 receptors compared to men (Seeman, 1983). Moreover, schizophrenic symptoms, generally less severe in women (Hafner, 2003), frequently worsen when estrogen is low (Hallonquist et al, 1993). Although the mechanisms by which estrogen and striatal D2 function interact with symptoms and therapeutic efficacy are not fully understood, the present study suggests that the effectiveness of medications which target D2 receptors may differ across the menstrual cycle phase.…”

Section: Discussionmentioning

confidence: 99%

Effect of Menstrual Cycle Phase on Dopamine D2 Receptor Availability in Female Cynomolgus Monkeys

Czoty

Riddick

Gage

et al. 2008

Neuropsychopharmacol

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Sex differences have been reported in a variety of affective and neurodegenerative disorders that involve dysfunctional dopamine (DA) neurotransmission. In addition, there is evidence for differences in sensitivity to the abuse-related effects of psychostimulants across the menstrual cycle which may result from effects of ovarian hormones on DA function. The goal of the present study was to extend previous work examining menstrual cycle-related changes in DA D2 receptor availability in humans to drug-naive female cynomolgus monkeys (n ¼ 7) using the selective D2-like receptor ligand [ 18 F]fluoroclebopride (FCP) and a high-resolution microPET P4 scanner. Menstrual cycle phase was characterized by daily vaginal swabs and measurements of serum progesterone levels. PET studies were conducted once during the luteal phase and once during the follicular phase. Regions of interest in the caudate nucleus, putamen, and cerebellum were defined on coregistered MRIs. Distribution volumes were calculated for FCP in each structure and the distribution volume ratio (DVR) for both brain regions relative to the cerebellum was used as a measure of D2 receptor availability. FCP DVRs were significantly higher in the luteal phase compared to the follicular phase in both the caudate nucleus (11.7% difference, p ¼ 0.02) and putamen (11.6% difference, p ¼ 0.03). These findings extend earlier work in humans and suggest that changes in DA receptor availability may be involved in the variation in symptoms of various neuropsychiatric disorders across the menstrual cycle, including differences in sensitivity to the abuse-related effects of stimulants.

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“…Gender differences in structural brain abnormalities (Nopolous et al, 1997; which develop prior to symptom onset (see Harrison, 1995 for review), and neuroleptic response also exist. Furthermore, symptom severity in female schizophrenics is correlated with fluctuating estrogen levels (Hallonquist et al, 1993). Exploring the effects of estrogen on cortical development therefore, may aid in the understanding of the disease process.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, males have a poorer response to neuroleptic treatment than females . Further implicating hormones in the disease process, symptom severity in female schizophrenics is correlated with fluctuating estrogen (EST) levels (Hallonquist et al, 1993) and schizophrenic women sometimes exhibit low EST levels in comparison to normal women (Oades and Schepker, 1994). Therefore, exploring the effects of EST on cortical development seems integral to the understanding of the disease process.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Dopamine and Estrogen upon Cortical Parvalbumin Expression

Ross¹

2001

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Physiology and Genetics, and the Neuroscience ProgramEstrogen plays a protective role in several neurologic disorders known to involve alterations in both the dopamine system and (gamma amino butyric acid containing) GABAergic neurons that contain parvalbumin. Two studies were conducted to identify the effects of estrogen and dopamine upon cortical parvalbumin expression. In the first study, organotypic slice cultures of the frontal cortex were prepared from male rats (postnatal age 2/3) and maintained for 14 days in serum-enriched medium or media containing either: dopamine, estrogen, or a combination of the two. In control slices, parvalbumin immunoreactive neurons were primarily clustered near cortical layer V. All treatment conditions increased the distribution of parvalbumin labeled neurons in layer VI and enhanced the maturation of dendritic measures of labeled neurons in the deep layers (V-VI). Both estrogen and the combination treatment induced similar alterations in the superficial cortical layers, as well. In the second study, gonadectomy (male rats, postnatal age 2) induced long lasting decreased in the density of parvalbumin immunoreactive neurons throughout all cortical layers. Estrogen replacement restored parvalbumin expression to control levels in the superficial cortical layers, only. Gonadectomy also Report Documentation PageForm Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Estrogen plays a protective role in several neurologic disorders known to involve alterations in both the dopamine system and (gamma amino butyric acid containing) GABAergic neurons that contain parvalbumin. Two studies were conducted to identify the effects of estrogen and dopamine upon cortical parvalbumin expression. In the first study, organotypic slice cultures of the frontal cortex were prepared from male rats (postnatal age 2/3) and maintained for 14 days in serum-enriched medium or media containing either: dopamine, estrogen, or a combination of the two. In control slices, parvalbumin immunoreactive neurons were primarily clustered near cortical layer V. All treatment conditions increased the distribution of parvalbumin labeled neurons in layer VI and enhanced the maturation of dendritic measures of labeled neurons in the deep layers (V-VI). Both estrog...

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Variation in symptom severity over the menstrual cycle of Schizophrenics

Cited by 134 publications

References 10 publications

Schizophrenia: do men and women suffer from the same disease?

Schizophrenia: do men and women suffer from the same disease?

Effect of Menstrual Cycle Phase on Dopamine D2 Receptor Availability in Female Cynomolgus Monkeys

The Effects of Dopamine and Estrogen upon Cortical Parvalbumin Expression

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