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Br J Pharmacol. 2019 Jan 18. doi: 10.1111/bph.14584. [Epub ahead of print]

Sex differences in schizophrenia, bipolar disorder, and post-traumatic stress disorder: Are gonadal hormones the link?

Author information

1
Hormones in Psychiatry Laboratory, Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia.
2
School of Medicine (Psychology), University of Tasmania, Sandy Bay, Tasmania, Australia.
3
Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.
4
Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia.
5
Centre for Mental Health, School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University, Melbourne, Victoria, Australia.
6
School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.

Abstract

In this review, we describe the sex differences in prevalence, onset, symptom profiles, and disease outcome that are evident in schizophrenia, bipolar disorder, and post-traumatic stress disorder. Women with schizophrenia tend to exhibit less disease impairment than men. By contrast, women with post-traumatic stress disorder are more affected than men. The most likely candidates to explain these sex differences are gonadal hormones. This review details the clinical evidence that oestradiol and progesterone are dysregulated in these psychiatric disorders. Notably, existing data on oestradiol, and to a lesser extent, progesterone, suggest that low levels of these hormones may increase the risk of disease development and worsen symptom severity. We argue that future studies require a more inclusive, considered analysis of gonadal steroid hormones and the intricacies of the interactions between them, with methodological rigour applied, to enhance our understanding of the roles of steroid hormones in psychiatric disorders.

PMID:
30658014
DOI:
10.1111/bph.14584

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