Association Between Age at Onset of Schizophrenia and Age at Menarche.

INTRODUCTION: Increasing evidence from clinical practice, as well as from epidemiological and basic research shows that there are gender differences in clinical features of schizophrenia, and this may be related to estrogens. There may be a relationship between earlier puberty and later onset of the disease, because of the protective effects of estrogens in women with schizophrenia. In this study, our aim was to analyze the correlation between age of menarche and age of onset of schizophrenia and to investigate the protective effects of estrogens in schizophrenia. METHOD: In this study, we included 289 patients who were diagnosed with schizophrenia. Those with mental deficiency or organic brain disorders were excluded from the study. All subjects were given a socio-demographic form to determine their personal information, age at menarche, age at first odd behavior, age at onset of the disease and first hospitalization. Data on factors which may affect the association between age at onset of schizophrenia and age at menarche such as family history, head or birth trauma etc. were recorded on the information form. RESULTS: We found out that age at menarche was negatively associated with age at first odd behavior and age at first psychotic symptoms. CONCLUSION: Our study verifies the protective effects of estrogens and shows that the earlier puberty may be the cause of later onset of schizophrenia. A gender-sensitive approach in psychiatry improves our understanding of mental illness and our therapeutic strategies.

Gray matter changes in patients with deficit schizophrenia and non-deficit schizophrenia.

OBJECTIVES: Reduced gray matter volume is a frequently reported finding in brain imaging studies performed with schizophrenia patients. Some studies suggest a probable link between the negative symptoms of schizophrenia and gray matter loss; however, some of the negative symptoms observed in schizophrenia patients are not primarily linked to the core of schizophrenia. This study aimed to compare gray matter volumes in patients with primary negative symptoms (deficit schizophrenia [DS]), non-DS (NDS) patients, and healthy controls. MATERIALS AND METHODS: The study included 11 DS patients, 18 non-DS patients, and 17 healthy controls. Magnetic resonance imaging (MRI) was performed using a 1.5 Tesla MR unit. The Schedule for Deficit Syndrome (SDS) was used to determine which patients were DS and non-DS. MR images were compared using voxel-based morphometry (VBM) analysis. RESULTS: Contrary to expectations, no evidence to support less gray matter in DS patients than in NDS patients was observed. Furthermore, NDS patients had less gray matter volume in several brain regions (frontal and temporal cortices) than did the DS patients. All patients had perisylvian gray matter volume deficits, though the NDS patients had more widespread volume deficiencies. CONCLUSION: No evidence to support the hypothesis that DS patients have less gray matter volume than those of NDS patients was observed. On the contrary, DS patients had more gray matter volume in some regions; the differences observed in gray matter volume in these brain regions between the 2 patient groups may be responsible for the differences in their clinical manifestations.

The disrupted connection between cerebral hemispheres in schizophrenia patients: a diffusion tensor imaging study.

AIM: In schizophrenia, the disruption of the communication between two brain hemispheres has not been shown clearly in the anatomical aspect despite other studies with different modalities suggested so. In this study, the structural integrity and the variables affecting the structural integrity of the corpus callosum, which is the main connection between two hemispheres, was investigated via diffusion tensor imaging (DTI). METHODS: The participants were evaluated by SCID-I and symptoms of the patients were assessed with PANSS. DT images of 25 schizophrenia patients and 17 healthy volunteers were acquired via 1.5 T MR. Fractioned Anisotropy (FA) values of two groups, measured on the DT images, were compared. RESULTS: It was found that fractioned anisotropy (FA) values were lower in the genu of the patients than the healthy controls; however, there was no difference between the FA values of the patients and the controls in the splenium. Moreover, a significant negative correlation between the splenium FA values and the antipsychotic medication doses; and a trend level negative correlation of splenium FA and PANSS scores were found. CONCLUSION: Corpus callosum is the most important structure that connects two frontal lobes. The hypothesis that posits the fundamental role of the disconnection of frontal lobes in schizophrenia is supported by the findings of this study.