Alterations in DHEA metabolism in schizophrenia: two-month case-control study.
OBJECTIVE
The goals of this study were to determine whether alterations in serum dehydroepiandrosterone (DHEA), its sulfated conjugate (DHEAS), androstenedione, testosterone, and progesterone concentrations occur in schizophrenia patients compared with healthy controls over two months, and their associations with psychopathology, emotional distress, and antipsychotic treatment.


METHODS
Serum hormones were repeatedly determined for 21 antipsychotic-treated male DSM-IV schizophrenia patients and 14 healthy controls. Observations were at four time points: upon entry into the study, and after 2, 4 and 8 weeks.


RESULTS
In schizophrenia patients compared with healthy controls serum concentration of DHEA and androstenedione found increased, but that of DHEAS decreased, while progesterone and testosterone showed normal levels. Schizophrenia patients were also characterized by elevated androstenedione/DHEAS molar ratios, and reduced DHEAS/DHEA and testosterone/androstenedione molar ratios compared with healthy controls. Concentrations and molar ratios of serum hormones did not significantly change during the study either among schizophrenia patients, or healthy controls. Among patients alterations in DHEA, DHEAS and androstenedione were associated with emotional distress, anxiety, dysphoric mood, positive and activation symptoms, serum prolactin levels, but were not related to age, antipsychotic agents, and extrapyramidal side effects.


CONCLUSIONS
Alterations in DHEA metabolism in schizophrenia are attributed to the distress, anxiety, severity of symptoms, prolactin levels, and may represent a marker for impaired hormonal responses to stress. These findings should be considered when evaluating the discrepancies in DHEA studies in schizophrenia.
Ritsner
Michael
M
Acute Department & Clinical Psychobiology Laboratory, Sha'ar Menashe Mental Health Center, Mobile Post Hefer, Hadera, Israel. ritsner@shaar-menashe.org
Gibel
Anatoli
A
Ram
Edward
E
Maayan
Rachel
R
Weizman
Abraham
A
D000328:Adult; D000375:Aging / Q000097:blood; D000735:Androstenedione / Q000097:blood; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology; D016022:Case-Control Studies; D003687:Dehydroepiandrosterone / Q000097:blood*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D004409:Dyskinesia, Drug-Induced / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D013739:Testosterone / Q000097:blood
D014150:Antipsychotic Agents; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D011374:Progesterone; D019314:Dehydroepiandrosterone Sulfate; D011388:Prolactin