Testosterone and gonadotropins but not estrogen associated with spatial ability in women suffering from schizophrenia: A double-blind, placebo-controlled study

SummaryThe aim of this study was to investigate the association between estrogen and spatial ability tasks in women suffering from schizophrenia. For this purpose, a placebo-controlled, double-blind, three-time cross-over study using 17β-estradiol combined with norethisterone acetate for replacement therapy and as an adjunct to a naturalistic maintenance antipsychotic treatment was carried out over a period of 8 months. Nineteen women (mean age=38.0 years, SD=9.9 years) with schizophrenia hospitalized for the first time or repeatedly were included in the study. Sex hormones — 17β-estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, testosterone, and dehydroepiandrosterone sulfate — were measured and the patients completed a neuropsychological test in the last two active drug and/or placebo phases. Three different spatial ability tasks — spatial orientation, spatial visualization, and flexibility of closure — were measured by a paper-and-pencil test. No association between estrogen and spatial ability was found; however, in an additional exploratory data analysis, high levels of testosterone, LH, and FSH correlated significantly with performance in the flexibility of closure task. This is the very first study, based on estrogen intervention instead of physiological hormone changes, to examine the association between estrogen and spatial ability in women with schizophrenia.