Abstract
Menopause is a process characterized by a decline in estrogen levels and is therefore a period of biological vulnerability for psychotic relapse in women with schizophrenia. Our goal was to correlate not only gonadal hormone levels but also follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels with improvement in specific clinical symptoms. Thirty-seven acutely ill postmenopausal schizophrenia women with a newly initiated, clinically determined change in antipsychotic medication participated in a 12-week prospective observational outcome study. Scales used were the PANSS scale for psychotic symptoms, the PSP for functioning, and CGI for global clinical impression. Circulating FSH, LH, estradiol, progesterone, and testosterone serum levels were determined by chemiluminescent immunoassay. Partial correlational analyses were performed along with a Bonferroni significance correction (p < 0.0007). After adjustment for confounding factors, the FSH/LH ratio correlated positively with mean changes in PANSS positive scores, and there was a correlation with worsening of CGI total and cognitive scores. Testosterone was also positively associated with improvement in PANSS positive scores. However, after correction for multiple testing, the initial correlations were no longer statistically significant. In summary, while the hormone assays we did in this small sample did not prove to be significantly linked to clinical improvement in any of the schizophrenia symptom domains, we recommend further investigation of pituitary, adrenal, and gonadal hormone ratios as potential markers of clinical improvement in this population.
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Acknowledgments
This study was supported by the Ministerio de Economía y Competitividad, Instituto de Salud Carlos III (FIS: PI11/02006) Fondo Europeo de Desarrollo Regional, Unión Europea, Un manera de hacer Europa, Centro de Investigación Biomédica en Red de salud Mental, CIBERSAM, and by the Government of Catalonia, Secretaria d’Universitats i Recerca del Departament d’Economia i Coneixement (2014SGR441).
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Alexandre González-Rodríguez was involved in the statistical analysis and interpretation of data. Alexandre González-Rodríguez and Miquel Bernardo wrote the first draft of the manuscript. Rafael Penadés supported statistical analyses and reviewed the paper. Bárbara Arias and Victoria Ruiz revised the manuscript. Mary V. Seeman critically revised the paper. Rosa Catalán supervised the whole project and revised the paper.
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Miquel Bernardo has been a consultant for, received grant/research support and honoraria from, and been on the speakers/advisory board of ABBiotics, Adamed, Boehringer, Eli Lilly, Ferrer, Forum Pharmaceuticals, Janssen-Cilag, Lundbeck, Otsuka, and Pfizer. Alexandre González-Rodríguez has received honoraria or paid for travels from Pfizer, Janssen, Lundbeck-Otsuka, and Ferrer. Rosa Catalán has received honoraria or has been paid for travels from Lilly, Lundbeck, Janssen, Ferrer, Pfizer, and Bristol. Rafael Penadés has received honoraria or paid for travels from Otsuka-Lundbeck and Janssen-Cilag. Victoria Ruiz-Cortés has been paid for registration at congresses from Janssen-Cilag. Mary V. Seeman has been a consultant for Clera Inc. The remaining authors have no conflicts of interest to declare.
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The research was approved by the Ethics Committee of the Hospital Clinic, and all participants gave their written informed consent to be included in the research.
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González-Rodríguez, A., Bernardo, M., Penadés, R. et al. Do FSH/LH ratio and gonadal hormone levels predict clinical improvement in postmenopausal schizophrenia women?. Arch Womens Ment Health 20, 613–620 (2017). https://doi.org/10.1007/s00737-017-0757-2
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DOI: https://doi.org/10.1007/s00737-017-0757-2