Sexual dimorphism in schizophrenia: is there a need for gender-based protocols?

Abstract

Gender differences have been reported in various aspects of schizophrenia, including its epidemiology, clinical course and the response to antipsychotic medications. Over the past few years the authors have been investigating sex differences in brain function in individuals with schizophrenia and have found an intriguing disturbance of normal sexual dimorphism during emotional and cognitive processing. These results can be partly accounted for by altered levels of sex steroid hormones (i.e., estrogen and testosterone) in patients. A handful of clinical research groups have tried low doses of estrogen, testosterone or their precursors as adjunct therapies to the currently available antipsychotic medications in women and men with schizophrenia. The results have been promising, but further investigation is warranted. In the future, new more specific steroidal compounds will be developed and we will see more studies examining sex differences in the brain, behavior and mental health problems. This research will help to identify individuals who may benefit greatest from adjunct hormonal therapies and will further our understanding of the etiology of schizophrenia and other psychiatric disorders.

Keywords::

• adjunct therapy
• estrogen
• schizophrenia
• sex differences
• sex steroid hormones
• testosterone

Financial & competing interests disclosure

Some of our research described in this article has been supported by the Canadian Institutes of Health Research (CIHR Institute of Gender and Health); Adrianna Mendrek has been supported by the Fonds de recherche en sante Quebec (FRSQ) and by the Louis-H Lafontaine Hospital Research Foundation; Emmanuel Stip is an Eli Lilly Chair of Schizophrenia Research at the University of Montreal. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.