Associations between the levels of estradiol, progesterone, prolactin and treatment response and quality of life in women with the first psychotic episode
Grodno State Medical University, Grodno, Republic of Belarus
Vestnik VGMU. 2019;18(2):88-95.
Objectives. To determine the associations between treatment response, quality of life and the level of estradiol, progesterone, prolactin in women with the first psychotic episode (FPE).
Material and methods. The study design is prospective, comparative, «case – control». The study included 98 women aged from 18 to 35 years: 55 patients with the FPE, 43 healthy women. The response to pharmacotherapy was determined by the degree of reduction of positive and negative symptoms within 4 weeks of observation. Quality of life was assessed using the Russian version of the MOS SF-36 questionnaire. Quantitative determination of blood serum hormones level was carried out by enzyme immunoassay.
Results. At the reproductive age in women with the normal menstrual cycle with the FPE compared to the control group, an increased level of prolactin was found, regardless of the phase of the menstrual cycle, and a reduced level of progesterone in the luteal phase. The comparison of female patients by the severity of psychopathological symptoms depending on the phase of the menstrual cycle showed a greater expressiveness of delusional symptoms in patients during the follicular phase. No statistically significant association was found between the degree of reduction of psychopathological symptoms during 4 weeks of observation and the blood serum concentration of prolactin, progesterone and estradiol in patients with FPE. The groups of patients with different levels of reduction of psychopathological symptoms did not differ in terms of quality of life. A negative association between the physical component of quality of life and the prolactin level was obtained.
Conclusions. At the beginning of treatment, female patients with FPE during the follicular phase of the menstrual cycle demonstrated more pronounced delusional symptoms in comparison with patients during the luteal phase. In the examined female patients, the effectiveness of antipsychotic therapy in the short term is not related to the peripheral level of sex hormones and prolactin, however, an increased prolactin level contributes to a decrease in the quality of life of patients with FPE.
Key words: first psychotic episode, treatment response, quality of life, prolactin, estradiol, progesterone.
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Information about authors:
Yankouskaya A.H. – senior lecturer of the Chair of Psychiatry and Narcology, Grodno State Medical University.