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A number of studies, mostly focusing on estrogen replacement therapy in women, have reported beneficial actions of these hormones on various neurobiological and neuropathological parameters in health and disease. Recent research has focused on gender differences and there is increasing evidence that estrogens exert protective effects in schizophrenia. Hormonal fluctuations or lack of estrogen may increase the risk of depression among vulnerable women. Treatment of depression with estrogen may stabilize and restore disrupted homeostasis – as during post-partum, premenstrual, or perimenopausal conditions – and act as a psychomodulator to offset vulnerability to dysphoric mood when estrogen levels are significantly decreased, as in the case of postmenopausal women. Studies on the effect of estrogens on Alzheimer’s Disease are still rather controversial, they do, however, facilitate the hypothesis that estrogens may have a modifying effect on the onset and course of AD, at least in subgroups of patients.
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Niels Bergemann Anita Riecher-Rössler (eds.) Estrogen Effects in Psychiatric Disorders
SpringerWienNewYork
Dr. Dr. Niels Bergemann Department of Psychiatry, University of Heidelberg, Germany
Prof. Dr. Anita Riecher-Rössler Psychiatric Outpatient Department, University of Basel, Switzerland
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© 2005 Springer-Verlag/Wien Printed in Austria
Springer WienNewYork is a part of Springer + Science Business Media springeronline.com
Typesetting: H. Meszarics • Satz & Layout • 1200 Wien, Austria Printing: Druckerei Theiss GmbH, 9431 St. Stefan, Austria Printed on acid-free and chlorine-free bleached paper SPIN: 10942017
With 40 Figures Library of Congress Control Number: 2004111514
ISBN 3-211-40485-6 SpringerWienNewYork
Contents Introduction and Overview (N. Bergemann, A. Riecher-Rössler) ...................... VII 1 Estrogens in Neuropsychiatric Disorders: From Physiology to Pathophysiology (H. Vedder, C. Behl) ............................................................
1
2 Estrogens and Schizophrenia (A. Riecher-Rössler) ........................................
31
3 Gender Differences in Schizophrenia (H. Häfner) .........................................
53
4 Puberty and Schizophrenia Onset (R. Z. Hayeems, M. V. Seeman) .............
95
5 Clinical Estrogen Trials in Patients with Schizophrenia (J. Kulkarni) ......... 107 6 Hypoestrogenism and Estrogen Replacement Therapy in Women Suffering from Schizophrenia (N. Bergemann, Ch. Mundt, P. Parzer, B. Runnebaum, F. Resch) ................................................................................ 123 7 The Effect of Estrogens on Depression (L. S. Kahn, U. Halbreich) .............. 145 8 Estrogens and Other Hormones in the Treatment of Premenstrual Syndromes (L. Born, M. Steiner) ..................................................................... 175 9 Estrogens and Perinatal Disorders (A. Gregoire) ............................................ 191 10 Estrogen Therapy in Perimenopausal Affective Disorders (G. Stoppe, M. Dören) ...................................................................