Utjecaj faze menstrualnog ciklusa na tijek psihotične epizode shizofrenije

master's thesis

• Title (english): Effect of menstrual cycle phase on the course of psychotic episodes in schizophrenia
• Author: Dejana Jezernik
• Mentor: Miroslav Herceg (mentor)
• Committee member: Neven Henigsberg (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Miroslav Herceg (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

Shizofrenija je teški duševni poremećaj koji zahvaća oko 1% populacije. Podjednako učestalo obolijevaju i muškarci i žene, no postoji razlika u tijeku, psihopatologiji i prognozi između spolova. Hormonske promjene koje se događaju nakon poroda, u menopauzi i u danima koji neposredno prethode menstruaciji mogu biti okidač za nastanak ili egzacerbaciju simptoma psihoze ili shizofrenije. Poznato je da estrogen, ženski spolni hormon, djeluje protektivno na razvoj shizofrenije u žena. Endogeni estrogen, 17β-estradiol, djeluje neuroprotektivno na mozak. Također, posjeduje i neuromodulatorni učinak na nekoliko neurotransmitorskih sustava, uključujući dopaminski, serotoninski i glutamatni, čija se disfunkcija nalazi u shizofreniji. Brojne studije dokazale su da u fazama niske razine cirkulirajućih spolnih hormona u krvi, osobito estradiola, dolazi do pogoršanja kliničke slike shizofrenije u smislu intenziviranja simptoma ili relapsa bolesti. Do redukcije pozitivnih i općih simptoma shizofrenije došlo je u fazama menstrualnog ciklusa u kojima je razina cirkulirajućeg estrogena u krvi bila visoka. U eksperimentalnim istraživanjima u žena oboljelih od shizofrenije koje su uz antipsihotike primale i estrogen došlo je do značajne redukcije pozitivnih simptoma (deluzija i halucinacija). Stoga se o estrogenu sve više razmišlja kao o „prirodnom antipsihotiku“ te su potrebna dodatna istraživanja kako bi se ustanovile terapijske mogućnosti estrogena u liječenju shizofrenije.

Abstract (english)

Schizophrenia is a severe mental disorder affecting 1% of the world population. It equally affects men and women, but there are differences between the course, psychopathology and prognosis between sex. Hormonal changes that occur after childbirth, the menopause and few days prior to menstrual bleeding can trigger or exacerbate the symptoms of psychosis or schizophrenia.It is known that estrogen, female sex hormone, exerts protective effects against schizophrenia in women. Endogenous estrogen, 17-β-estradiol, has a neuroprotective effect on the brain. It also acts as a neuromodulator on several neurotransmitter systems, including dopaminergic, serotonergic and glutamatergic systems, which are all dysregulated in schizophrenia. Numerous studies have shown that during times of low circulating sex hormones especially estradiol, women with schizophrenia demonstrate increased symptom severity and greater relapse rates. The reduction of positive and general symptoms was reported during phases of the menstrual cycle with high circulating levels of estrogen. In experimental studies, there was a significant reduction in the positive symptoms (delusion and hallucination) of schizophrenia in women who received estrogen as an addition to antipsychotics. Therefore, estrogen is more often considered as „natural antipsychotic“. Further research is needed to establish therapeutic options of estrogen in the treatment of schizophrenia.

• Keywords: estrogenska hipoteza; menstrualni ciklus; psihotična epizoda; shizofrenija
• Keywords (english): estrogen hypothesis; menstrual cycle; psychopathology; schizophrenia
• Language: croatian
• URN:NBN: urn:nbn:hr:105:914380
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-05-11 06:55:57