title: Sex differences in prolactin levels in emerging psychosis: Indication for enhanced stress reactivity in women.
abstract: Hyperprolactinemia is a known side effect of antipsychotics. In recent reports it has also been shown in antipsychotic-naïve at-risk mental state (ARMS) and first-episode psychosis (FEP) patients. Prolactin is not only involved in reproduction and lactation, but is also synthesized in response to stress. As stress is thought to play an important role in the onset and relapse of schizophrenia, the aim of this study was to further elucidate the influence of prolactin in emerging psychosis.
  
  
  
  The data analysed in this study were collected within the prospective Früherkennung von Psychosen (FePsy) study. Blood sample collection took place under standardized conditions between 8 and 10am after an overnight fast and 30minutes of rest. All patients were antipsychotic-naïve and did not take any prolactin influencing medication.
  
  
  
  Our sample consisted of 116 antipsychotic-naïve ARMS and 49 FEP patients. Hyperprolactinemia was shown in 32% of ARMS and 35% of FEP patients. After correction for the normal biological variation between the sexes, we still found higher average prolactin levels in female than in male patients (β=0.42; t=2.47; p=0.01) but no difference in prolactin levels between ARMS and FEP patients (β=-0.05; t=-0.30; p=0.76). The survival analysis revealed no significant predictive value for prolactin levels to predict transition to psychosis.
  
  
  
  Our findings support a possible role of prolactin in emerging psychosis and it could be speculated that stress, which can induce hyperprolactinemia, has a stronger effect on women than on men in emerging psychosis.
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ittig
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Erich
authors.initials: E
authors.lastname: Studerus
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Heitz
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Menghini-Müller
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Beck
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Laura
authors.initials: L
authors.lastname: Egloff
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Letizia
authors.initials: L
authors.lastname: Leanza
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland.
authors.forename: Christina
authors.initials: C
authors.lastname: Andreou
authors.affiliation: Center for Gender Research and Early Detection, University of Basel Psychiatric Hospital, Basel, Switzerland. Electronic address: anita.riecher@upkbs.ch.
authors.forename: Anita
authors.initials: A
authors.lastname: Riecher-Rössler
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D011388:Prolactin / Q000097:blood* / Q000187:drug effects; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D011618:Psychotic Disorders / Q000097:blood* / Q000188:drug therapy / Q000523:psychology; D012189:Retrospective Studies; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D011388:Prolactin
keywords: Blood levels; Clinical high-risk; Gender differences; Schizophrenia; Stress hormone