Anti-müllerian hormone and sex hormone levels in schizophrenia

Background: Schizophrenia exhibits a gender-biased dimorphic character, as males experience an earlier onset of the disorder and more pronounced negative and cognitive symptoms than females. Idea of Anti-Müllerian hormone (AMH) as a candidate participant for schizophrenia etiology, symptoms or severity comes from its effect on gonadotropin and steroid hormone synthesis, gender specific behaviors, and neuronal viability and function. In this study we aimed to investigate AMH and sex hormone levels in schizophrenia. Methods: Present study included 51 male patients with schizophrenia at acute exacerbation and 40 healthy age and gender matched control subjects. 22 of the patient group were re-evaluated after 6-8 weeks naturalistic treatment. Schizophrenia diagnosis was assessed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. Clinical Global Impression (CGI) and Positive and Negative Syndrome Scale (PANSS) scores are recorded. AMH levels were analyzed by Beckman Coulter® AMH Gen II ELISA reagents. Hormone analyses were performed with Roche reagents according to the manufacturers? instructions. Results: Patients with schizophrenia had lower total and free testosterone levels than the control group. Post treatment free and total testosterone levels were significantly decreased compared to basal levels. AMH levels were not different neither between the patient- control groups nor basal-post treatment periods. However paranoid type had lower AMH levels than the disorganized type. A general linear analysis model, pre-treatment AMH levels as the dependent variable revealed significant effect of PANSS negative and CGI scores (p<0.01). Discussion: This study reveals low testosterone levels in male patients with schizophrenia at acute exacerbation and a significant decrease following drug therapy, suggesting possible role of androgens in etiology of schizophrenia and at treatment period. The significant relations between AMH levels and disease subtypes as well as PANSS negative, CGI scores of the patients indicate that AMH may affect disease symptoms and severity through affecting behavioral models or sex hormone metabolism. Key words: Anti-Müllerian hormone, estradiol, schizophrenia, sex hormone binding globulin, testosterone