The theory that many serious mental illnesses, in particular psychoses such as schizophrenia, may have a significant hormonal aetiological component is fast gaining popularity and the support of scientific evidence. Oestrogen in particular has been substantially investigated as a potential mediator of brain function in schizophrenia. Epidemiological and life-cycle data point to significant differences in the incidence and course of schizophrenia between men and women suggests a protective role of oestrogen. In vitro and in vivo preclinical research confirms oestradiol’s interactions with central neurotransmitter systems implicated in the pathogenesis of schizophrenia, while results from randomised controlled trials investigating the antipsychotic potential of oestrogen have been positive. Research into other neuroactive hormones with possible effects on mental state is a rapidly evolving field that may hold new promise. Given that schizophrenia and related psychoses are pervasive and debilitating conditions for which currently available treatments are often only partially effective and entail a high risk of serious side-effects, novel therapeutic strategies are needed. The literature reviewed in this paper suggests that hormones such as oestrogen could be a viable option, and it is hoped that with further research and larger trials, the oestrogen hypothesis can be translated into effective clinical practice. 1. Introduction Over a century ago, the father of modern psychiatry Emil Kraepelin first implicated an imbalance of sexual hormones in the aetiology of “dementia praecox” [1], and reports of gonadal dysfunction in psychotic patients have also been well documented since this time [2]. However it is only with recent scientific advances that the considerable effects of reproductive hormones on central nervous system functioning and mental health have come to light. Such evidence has led multiple researchers [3–6] to investigate the role of oestrogen in the pathogenesis of psychosis and propose the “oestrogen protection hypothesis” and the “hypothesis of hypoestrogenism” as possible explanations for gender differences in schizophrenia. This paper provides a summary of the current literature with the intention of highlighting the likely role and clinical importance of oestrogen and other reproductive hormones in psychotic illness, in particular in the field of women’s mental health. 2. Case Study Miss R was a 52-year-old woman with a history of schizophrenia which began after the birth of a child she gave up for adoption in her late twenties. She had
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