Research view
Title: | Evaluation of prolactin levels in male patients with first-episode schizophrenia and its correlation with psychopathology |
Author: | Mohamed El Sayed El Taweel and Ahmed Mohamed Abdalla |
Abstract: |
Background
Prolactin, a polypeptide hormone secreted by lactotroph cells of the anterior pituitary
gland, is involved in many biological functions including reproduction, pregnancy, and
lactation. A variety of studies over the past four decades have examined other facets of
the relationship between prolactin and schizophrenia and call for a reappraisal of this
relationship. Some recent studies have found increased prolactin concentrations in
antipsychotic-naive psychotic patients, whereas other studies of previously treated but
drug-free patients reported concentrations that are normal or lower than those in
controls.
Objective
The aim of this study was to determine whether there is a significant rise in serum
prolactin in psychotropic drug-naive male patients with first-episode schizophrenia
related to disease process and its correlation with psychopathology.
Patients and methods
Thirty male patients with first-episode schizophrenia were included in this crosssectional
study. Patients were drug-free and psychotropic drug-naive. The patients
were classified into two groups: those with and those without hyperprolactinemia.
Plasma levels of prolactin and demographic and clinical characteristics were
compared between these groups. Standardization for control was carried out using 30
control plasma prolactin samples obtained from healthy individuals. Methodology
involved assessment by means of radioimmunoassay. For schizophrenic patients,
clinical evaluation was carried out by measuring the Premorbid Adjustment Scale
(PAS), the Positive and Negative Syndrome Scale, and the Montgomery–Asberg
Depression Rating Scale. The scores for these scales were significantly higher in the
hyperprolactinemia group than in the nonhyperprolactinemic group.
Results
Serum prolactin level was elevated at baseline in 46.7% of first-episode schizophrenic
patients. Duration of untreated psychosis and poor premorbid adjustment (PAS) were
significantly higher in the group with hyperprolactinemia than in the
nonhyperprolactinemic group. In addition, total Positive and Negative Syndrome Scale
scores, negative symptom scores, and Montgomery–Asberg Depression scores in the
group with hyperprolactinemia were significantly higher than that in the
nonhyperprolactinemic group. There was also a positive correlation between plasma
levels of prolactin and duration of untreated psychosis, PAS, negative symptom scores,
and Montogomery–Asberg Depression scores.
Conclusion
This study suggests that we should be aware of prolactin levels in first-episode
schizophrenic patients, especially when negative and depressive symptoms are
prominent. Thus, this finding may change the present pharmacotherapy for negative
and depressive symptoms in schizophrenia based on prolactin levels.
Keywords:
first episode, prolactin, psychopathology, schizophrenia
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Journal: | Middle East Curr Psychiatry 24:49–54 |
Text: | |
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