Older literature had repeatedly documented that physically frail male schizophrenics tended to be withdrawn with apathy, blunted affect and poor prognosis. However, in female schizophrenics, signs of virilism portend poor prognosis and severe deterioration. Three published studies of 92 male schizophrenics, from India, Iran and Japan, showed negative correlations between testosterone (T) levels and negative symptoms.

Twenty-eight (18 male and 10 female) patients, aged 25-67 (mean=34.8) years, who fulfilled DSM-IV TR criteria for schizophrenia were selected, with the approval of local ethical committee. Serum levels of T, dihydrotestosterone and DHEA were estimated by radioimmunoassay. Neuropsychological tests were administered for each patient. Pearson correlation test, linear regression analysis and independent ‘t’ test were used for statistical analysis.

Mean PANSS score for all 28 patients was 82.3; 18 patients had predominantly positive symptoms and 10 had predominantly negative symptoms. Independent ‘t’ test did not show any significant difference for any of the serum hormone levels between the groups of patients based on PANSS scores. However, when women were excluded, T levels were significantly lower in negative symptom dominant group (p=0.05). A correlation between serum T levels, but not of other hormones, and the total scores on all neuropsychological test results was also noted (p=0.017); verbal fluency showed the greatest correlation, followed by working memory. But when women were excluded, this significance disappeared.

Negative symptoms correlate negatively with T levels, but only in men. Neuropsychological findings correlate with T levels as well.