Testosterone levels and clinical features of schizophrenia with emphasis on negative symptoms and aggression

Abstract

Background: Aggressive behavior and negative symptoms are two features of schizophrenia that may have a hormonal basis. Aim: The aim of this study was to compare testosterone level with clinical features of schizophrenia, focusing on negative symptoms and aggressive behavior. Methods: The study population consisted of 120 male schizophrenic patients (ages 18–40) classified into non-aggressive (n = 60) and aggressive (n = 60) groups. Depending on the type of aggression that was manifested prior to admission, the aggressive group was divided into violent (n = 32) and suicidal (n = 28) subgroups. Psychopathological severity, violence and suicidality were assessed using the Positive and Negative Syndrome Scale (PANSS), Overt Aggression Scale and Columbia Suicide Severity Rating Scale, respectively. Total serum testosterone level was determined on the same morning that symptoms were assessed. Results: In the non-aggressive group, testosterone level was negatively correlated with the score on the negative subscale of PANSS (P = 0.04) and depression (P = 0.013), and positively correlated with excitement (P = 0.027), hostility (P = 0.02) and impulsive behavior (P = 0.008). In the aggressive group, testosterone level had non-significant correlation with these parameters, and with violent or suicidal behavior. Conclusions: The results confirmed that non-aggressive male schizophrenic patients with lower levels of testosterone had a greater severity of negative symptoms. In aggressive patients, there was no correlation between testosterone and clinical features of the disorder or the degree or type of aggression. These findings indicate that therapeutic strategies targeting testosterone could be useful in the treatment of negative symptoms of schizophrenia.

• Aggressiveness
• Clinical features
• Negative symptoms
• Schizophrenia
• Testosterone

Acknowledgements

The authors gratefully acknowledge the support of the staff in the University psychiatric hospital Vrapče and the laboratory of the Polyclinic “Bonifarm”, for making this research possible. Ethical approval received from the Ethic Committee of University Psychiatric Hospital Vrapče, 2008.

Competing interests

All authors have completing the Unified Competing Interest form at (available on request from the corresponding author) and declare: no support from any organization for submitted work; no financial relationship with any organizations that might have any interest in the submitted work in the previous 3 years; no other relationship or activities that could appear to have influenced the submitted work.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.