DHEA and DHEA-S levels in hospitalized adolescents with first-episode schizophrenia and conduct disorder: a comparison study.

Introduction: Increasing evidence exists indicating an association of DHEA and DHEA-S blood levels with psychosis, however many of the findings remain contradictory based on different phases of the illness, different treatments and at a range of ages. To date no studies exist investigating the levels of these neurosteroids in adolescents with psychosis. Such an investigation would be important in order to exclude effects of chronic illness, long-term treatment and repeated hospitalizations. Method: Peripheral venous blood samples for DHEA, DHEA-S and cortisol determination were collected from first-time hospitalized adolescents with diagnoses of schizophrenia as well as from patients with conduct disorder. Patients were rated with the Positive and Negative Syndrome Scale (PANSS), the Hamilton Scale for depression (HAM-D), the Overt Aggression Scale (OAS) and the impulsivity scale (IS). Results: DHEA levels in adolescents with schizophrenia were significantly higher than in patients with conduct disorder (p = 0.002). Blood levels of DHEA and DHEA-S in schizophrenia correlated with the total PANSS scores (both p b 0.05). No correlations were detected between any of the neurosteroid blood levels and clinical rating scales in the control group. Conclusions: It may be proposed that individuals in their early stages of schizophrenia psychosis may develop a protective or compensatory neurosteroid response to the first onset of psychosis. Such a putative upregulatory DHEA mechanism may become desensitized with progression to chronic illness. The temporal relationship of investigation of neurosteroid levels in adolescents compared to such investigation in adults may provide important and relevant information.