DO ESTROGENS HAVE ANTIPSYCHOTIC PROPERTIE S

Within the framework of our ABC study, an epidemiological study on sch izophrenia (Hafner et al., 1989, 1991a; Riecher et al., 1991), we were able to show that the mean age at onset of the disease is 3-4 years h igher in women than in men and that women have a second peak of onsets after 45 years of age. In a systematic analysis we developed and test ed different psychosocial and biological explantory hypotheses. The oe strogen hypothesis could be identified in the course of this analysis as the most plausible one. According to this hypothesis (Hafner; 1987) female sex hormones enhance the vulnerability threshold for schizophr enia. In this case women from puberty to (pre-)menopause would be prot ected from the outbreak of the disease to a certain extent by their hi gh physiological oestradiol production; they would, however, later ''d raw level'' in respect of morbidity risk. Animal experiments conducted to test this hypothesis and to explain the underlying pathophysiologi cal mechanism implied that oestradiol can modulate the sensitivity of dopamine-D-2-receptors in the brain (Hafner et al., 1991 b; Gattaz et al., 1992). In the clinical study presented, we examined the validity of the oestrogen hypothesis in humans. We tested, whether the acute sy mptomatology of schizophrenic patients fluctuates with oestradiol seru m levels during the female menstrual cycle. We examined 32 acutely adm itted schizophrenic women during their hospital stay by analysing horm onal parameters and applying various rating scales for psychopathology on certain days of the cycle. A significant association emerged betwe en oestradiol levels on the one hand, and psychiatric symptomatology, behaviour on ward, paranoid tendencies and general well-being, on the other. Psychopathology seemed to improve significantly when oestradiol levels rose, and vice versa. We interpreted this finding as further e vidence for a protective effect of oestradiol in schizophrenia, probab ly mainly due to the presumably antidopaminergic property of this horm one, which is suggested by many other recent studies as well.