Testosterone levels and clinical features of schizophrenia with emphasis on negative symptoms
and aggression
Sammanfattning
Background: Aggressive behavior and negative symptoms are two features of schizophrenia that
may have a hormonal basis. Aim: The aim of this study was to compare testosterone level with
clinical features of schizophrenia, focusing on negative symptoms and aggressive behavior.
Methods: The study population consisted of 120 male schizophrenic patients (ages 18-40) classified
into non-aggressive (n = 60) and aggressive (n = 60) groups. Depending on the type of aggression
that was manifested prior to admission, the aggressive group was divided into violent (n = 32) and
suicidal (n = 28) subgroups. Psychopathological severity, violence and suicidality were assessed
using the Positive and Negative Syndrome Scale (PANSS), Overt Aggression Scale and Columbia
Suicide Severity Rating Scale, respectively. Total serum testosterone level was determined on the
same morning that symptoms were assessed. Results: In the non-aggressive group, testosterone
level was negatively correlated with the score on the negative subscale of PANSS (P = 0.04) and
depression (P = 0.013), and positively correlated with excitement (P = 0.027), hostility (P = 0.02) and
impulsive behavior (P = 0.008). In the aggressive group, testosterone level had non-significant
correlation with these parameters, and with violent or suicidal behavior. Conclusions: The results
confirmed that non-aggressive male schizophrenic patients with lower levels of testosterone had a
greater severity of negative symptoms. In aggressive patients, there was no correlation between
testosterone and clinical features of the disorder or the degree or type of aggression. These findings
indicate that therapeutic strategies targeting testosterone could be useful in the treatment of negative
symptoms of schizophrenia.