Neurobiological aspects of psychosis and gender

In comparison to female schizophrenia patients male patients have more impaired premorbid functioning, earlier onset of disorder, more severe symptomatology, less favourable outcome, different structural brain abnormalities and cognitive deficits. It has been hypothesized that estrogen, with effects on both neurodevelopment and neurotransmission, could play a protective role in women with schizophrenia and account for some of the gender differences observed in the disorder. On the other hand, it is known that altered promoter DNA methylation could play a critical role in mediating differential regulation of genes and in facilitating short-term adaptation in response to the environment. This data could indicate that environmental factors have gender specific influence on DNA methylation changes in schizophrenia. Recent data support the epigenetic theory of major psychosis and suggest that DNA-methylation changes are important to the etiology of psychosis in a gender specific pattern. Clinically observed gender differences in schizophrenia are probably influenced by genetic and environmental factors. The interplay between those two sets of factors is mediated by estrogen and epigenetic mechanisms.