Estradiol levels in psychotic disorders

Estradiol has been postulated to constitute a protective factor for schizop hrenia, which could provide women at risk to experience a psychotic episode with a relative protection in phases of high estradiol levels, i.e. before menopause and during the peri- and postovulatory phases of their cycle. Wo men suffering from schizophrenia have been reported to show significantly l ower estradiol levels than the normal population and to experience first on set or recurrence of a psychotic episode significantly more often in low es trogen phases of the cycle with low estradiol levels. We examined estradiol levels in an open prospective study in 43 women admitted with a diagnosis of an acute psychotic episode and could confirm these findings for schizoph renia as well as other psychotic disorders. Only 28% of the women exhibited estradiol and progesterone levels indicating a peri- or postovulatory phas e and all of the estradiol levels on admission were either within the lower part of the cycle-dependent normal range or below normal; comparison with a control group of healthy volunteers and patients admitted with different psychiatric diagnoses confirmed their estradiol levels to be significantly higher. However, when splitting this control group, the statistical differe nce would only hold between the study group of psychotic patients and the h ealthy control group. The group of patients with other diagnoses than a psy chotic episode fell in between of the other two groups and did not differ s ignificantly from either. Thus, an unspecific effect, i.e. a hypothalamic d ownregulation due to the stress of acute hospitalization must be born in mi nd when assessing hormone levels in acutely psychotic women. (C) 2000 Elsev ier Science Ltd. All rights reserved.