Sex differences in prolactin levels and clinical outcomes in patients with a first psychotic episode

IF 3.4 2区医学 Q2 ENDOCRINOLOGY & METABOLISM Psychoneuroendocrinology Pub Date : 2024-07-14 DOI:10.1016/j.psyneuen.2024.107112

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Abstract

Aim

To analyze the clinical, neurocognitive, and functional impact of prolactin levels according to sex in patients with a First Episode Psychosis (FEP).

Methods

We measured prolactin levels in 221 non-affective FEP patients treated with antipsychotics (AP) and 224 healthy controls, at baseline and 2-year follow-up. We examined whether the relationships between clinical and functional variables were mediated by prolactin, controlling for antipsychotic use, according to sex.

Results

Prolactin levels were higher in patients when compared to controls at both time points. Baseline factors associated with prolactin were chlorpromazine equivalents, attention, and executive functioning. In the FEP group, prolactin levels were associated with functioning and diminished expression in males, and with working memory in females. Prolactin levels (p=0.0134) played a role as a mediator between negative symptomatology (p=0.086) and functional outcome (p=0.008) only in FEP male patients at baseline.

Conclusions

Prolactin plays a role in the functionality and clinical symptomatology of FEP patients. Our results suggest that pharmacological counselling in patients with hyperprolactinemia at baseline and negative symptomatology might improve their functional and clinical outcomes.

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首次精神病发作患者催乳素水平和临床结果的性别差异

目的分析催乳素水平对首发精神病（FEP）患者的临床、神经认知和功能的影响。方法我们测量了221名接受抗精神病药物（AP）治疗的非情感性FEP患者和224名健康对照者在基线和2年随访期间的催乳素水平。在控制抗精神病药物使用的情况下，我们根据性别研究了临床和功能变量之间的关系是否受催乳素介导。结果在两个时间点，患者的催乳素水平均高于对照组。与催乳素相关的基线因素是氯丙嗪当量、注意力和执行功能。在 FEP 组中，男性催乳素水平与功能和表达能力减弱有关，女性催乳素水平与工作记忆有关。泌乳素水平（p=0.0134）在负性症状（p=0.086）和功能结果（p=0.008）之间起着中介作用，仅适用于基线时为 FEP 的男性患者。我们的研究结果表明，对基线高泌乳素血症患者进行药物咨询并改善其不良症状，可能会改善他们的功能和临床预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychoneuroendocrinology 医学-精神病学

CiteScore

7.40

自引率

8.10%

发文量

268

审稿时长

66 days

期刊介绍： Psychoneuroendocrinology publishes papers dealing with the interrelated disciplines of psychology, neurobiology, endocrinology, immunology, neurology, and psychiatry, with an emphasis on multidisciplinary studies aiming at integrating these disciplines in terms of either basic research or clinical implications. One of the main goals is to understand how a variety of psychobiological factors interact in the expression of the stress response as it relates to the development and/or maintenance of neuropsychiatric illnesses.