Numerous features of the schizophrenic psychosis point to an immature level of psychosexual functioning. The question is raised whether this is due to deficiency of sex hormone. It is pointed out that sexual behavior in animals is largely determined by this factor: mating activity can be prevented by castration and precocious sex behavior can be induced by the use of primary sex hormones. The schizophrenic patient, however, usually has normal genitalia and probably excretes sex hormone in an approximately normal amount. Furthermore, castration in human beings seldom if ever gives rise to schizophrenia, nor does that operation have much influence on the psychosis if performed after its development.
Although quantitative alterations in the sex hormone titre show little correlation with the psychosis it is theoretically possible that variations in responsivity to the hormones might be a factor. That such responsivity varies widely under different conditions is well known. Dissociation between the somatic and the psychodynamic reactions to the sex hormones is also possible under numerous conditions, e.g., precocious puberty in boys and girls is commonly not accompanied by much eroticism. Dissociation between sex hormone production and mating response can be demonstrated experimentally by the induction of lesions in the hypothalamus.
Another theoretical possibility is that schizophrenia might be induced by imbalance in the titres of circulating androgen and estrogen as homosexuality is believed by some to be produced. This possibility is controverted by the infrequency with which administered sex hormone benefits homosexuality and by the fact that acquired sex reversal in man does not lead to schizophrenic symptomatology.
Whether or to what extent schizophrenia might be due to qualitative abnormalities of sex hormone production is discussed. Evidence is cited that certain animals are more responsive in terms of sex behavior to stallion-urine extract than to testosterone. Evidence of aberrant sex hormone production in man is, however, lacking. Likewise lacking is evidence that the psychosexual perturbations of schizophrenia might be due to abnormalities in the metabolism of normal sex hormone.
It seems probable that the psychosexual disharmony of schizophrenia is not to be ascribed therefore to immediate abnormality in either amount, balance or chemical nature of the sex hormones. The possibility remains that abnormal responsivity to these hormones might account for the psychosis and that successful normalization of the responsivity might be an effective therapeutic procedure.
