Gonadal function and its influence on psychopathology

In a recent clinical study we have shown that the psychopathology of 32 schizophrenic female inpatients varies with estradiol serum levels throughout the menstrual cycle. Symptomatology – apart from depression – seems to improve when estradiol blood levels rise and vice versa. Furthermore we found considerable menstrual irregularities and hormonal disturbances in most schizophrenic women (Riecher-Rössler et al., 1994).

We have now tested the specifity of our results for schizophrenia by examining 29 age-matched women, admitted for acute psychiatric disorders other than schizophrenia. In these patients, mainly suffering from depressive disorders, symptomatology did not correlate with estradiol levels. The only exception was general behavior on ward. The results imply a clinical effect of estrogens similar to that of a weak neuroleptic. Gonadal function during the acute episode was significantly more disturbed in the schizophrenic than in the control patients. If there also is a subgroup of schizophrenic women with preexisting, chronic gonadal hypofunction as was implied by the old theory of "hypoestrogenism" in schizophrenia, could not be definitely answered. It is proposed, however, that low estrogen levels of any origin can lead to the outbreak/deterioration of schizophrenic symptoms in vulnerable women.