Serum DHEA-S, Testosterone and Cortisol Levels in Female Patients with Schizophrenia.

OBJECTIVE: To compare the relation symptom severity and testosterone levels, and DHEA-S and cortisol in premenopausal women with schizophrenia and an age- and sex-matched control group. METHODS: Thirty-two women with schizophrenia and 32 age- and sex-matched healthy controls were included in the study. All participants were aged between 20 and 45 years, and their previous treatments were olanzapine (n=14) and quetiapine (n=18). Symptom severity was assessed using the Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS). A chemiluminescence immunoassay was used to investigate hormone profiles of the two groups, which were then compared and analyzed. The relation between the hormone levels and SANS and SAPS scores of the study group and controls was examined. RESULTS: There were statistically significantly higher levels of serum DHEA-S (p=0.002) in the study group than in the control group. No statistically significant difference was determined between the groups regarding serum testosterone and cortisol levels. A positive correlation was determined between the study groups' SANS scores and DHEA-S levels (p=0.012, r=0.440). CONCLUSION: DHEA-S might be a potential biologic marker for schizophrenia because there is evidence of an association between DHEA-S and the pathophysiology of schizophrenia. However, further research with greater patient numbers is required to verify these findings.

The Effect of Antipsychotics on Bone Mineral Density and Sex Hormones in Male Patients with Schizophrenia.

BACKGROUND: The aim of this study was to compare the bone mineral density (BMD) of male schizophrenia patients with those of healthy controls in order to determine the relationship between BMD and hormonal changes. SUBJECTS AND METHODS: The study sample included male outpatients between 18 and 55 years old, diagnosed with schizophrenia who had used prolactin-raising antipsychotics (n=23) and prolactin-sparing antipsychotics (n=19) for at least twelve months, along with an age - matched healthy control group. A socio-demographic form was administered, BMD and T-score measurements were performed with a DEXA test, and hormone levels were measured with commercial test kits. RESULTS: The prolactin levels of the prolactin-raising group (PRG) were significantly higher than those of the healthy control group (CG) and the prolactin-sparing group (PSG). While prolactin levels were normal in the CG, hyperprolactinemia was found in 15.8% (n=3) of patients in the PSG and 65.2% (n=15) of subjects in the PRG. Estradiol levels for the PRG and PSG were similar but significantly lower than those of the CG. There was a statistically significant difference between the PRG, PSG and CG in terms of their L1-4 total actual bone density and T-scores. BMD and T-scores were lower for the PRG in comparison with the PSG and CG, and were consistent with osteopenia. Although not observed for every tested region, a negative correlation was found between age, duration of therapy, duration of illness, and T-scores. A positive correlation was found between subjects BMI and T-scores. A consistent negative correlation was found between total testosterone and L1-4 total T-scores when corrected according to prolactin and estradiol. A linear regression analysis found significant relationships between age, BMI, duration of therapy, duration of illness, chlorpromazine equivalent dose, estradiol and testosterone affected T-scores for some regions. CONCLUSIONS: The long-term use of prolactin - raising antipsychotic medications as well as hyperprolactinemia and hypoestrogenism accelerate bone degradation.

Aripiprazole augmentation of serotonin reuptake inhibitors in treatment-resistant obsessive-compulsive disorder: a 10-week open-label study.

INTRODUCTION: Studies investigating the aripiprazole augmentation treatment of serotonin reuptake inhibitor (SRI)-resistant obsessive-compulsive disorder (OCD) are insufficient. The aim of the present pilot study was to investigate the efficacy and tolerability of flexible doses of aripiprazole as an augmenting agent in SRI-resistant OCD patients. METHODS: OCD patients who met the criteria of this study were followed up with flexible doses of aripiprazole augmentation over a 10-week period. Effectiveness of treatment was evaluated via the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Clinical Global Impressions-Severity of Illness (CGI-S) and -Improvement (CGI-I) scales. At the end of the 10-week follow-up period, patients who showed an improvement of ≥30% for the Y-BOCS total score from baseline were considered responders. RESULTS: Thirty patients met the study inclusion criteria; three patients did not agree to participate, and four patients dropped out of the study. The differences between baseline and scores at 10 weeks for the parameters studied were as follows: Y-BOCS scores: 32.0±6.3-24.0±8.1 (Z=4.2, P<0.05); Y-BOCS compulsion subscore: 15.0±4.2-11.5±4.3 (Z=4.01, P<0.05); Y-BOCS obsession subscore: 17.0±2.6-12.4±4.0 (Z=4.1, P<0.05); and CGI-S scores: 4.8±0.8-3.1±1.2 (Z=3.9, P<0.05). Patients showed a significant improvement over the 10-week study period; however, only seven of 23 patients (30.4%) who completed the study met the criteria determined for treatment response. CONCLUSION: Despite the limited number of cases and open-label design of this study, results support the notion that adding aripiprazole to SRIs could be a valid strategy for treatment-resistant OCD patients.

Causal attributions and alexithymia in female patients with fibromyalgia or chronic low back pain.

AIMS: Our general objective was to assess the psychological symptoms and the types of causal attributions linked to the symptoms among women chronic pain. METHODS: 70 fibromyalgia (FM) patients, 56 chronic low back pain (CLBP) patients and 72 healthy controls were assessed within a general hospital setting, using the Toronto Alexithymia Scale, Brief Symptom Inventory and Symptom Interpretation Questionnaire. Three-way analysis of variance and chi-square tests were used for inter-group comparisons, followed by multivariate correlation, covariate analysis and linear regression. RESULTS: Alexithymia, somatization, depression, anxiety and hostility scores were significantly higher in FM patients relative to CLBP patients and healthy controls (P < 0.05). Alexithymia was linked to psychological attributions in FM patients and to somatic attributions in CLBP patients. Psychological attributions, the number of symptoms and difficulty in describing emotions were related to increased anxiety in FM patients. Depression, anxiety and somatization were significantly increased in subjects with high alexithymia scores in the FM group. There was no difference between groups regarding causal attributions. CONCLUSIONS: Causal attributions do not seem to have distinctive features between functional somatic syndromes like FM and CLBP, though differences might exist between groups as to the effects of coexisting psychological distress symptoms like anxiety and depression.