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Review
. 2017 Sep:80:36-56.
doi: 10.1016/j.neubiorev.2017.05.007. Epub 2017 May 12.

Oxytocin effects in schizophrenia: Reconciling mixed findings and moving forward

Ellen R Bradley  1 , Joshua D Woolley  2
Affiliations
Review

Oxytocin effects in schizophrenia: Reconciling mixed findings and moving forward

Ellen R Bradley et al. Neurosci Biobehav Rev. 2017 Sep.

Abstract

Schizophrenia is a severe mental illness that causes major functional impairment. Current pharmacologic treatments are inadequate, particularly for addressing negative and cognitive symptoms of the disorder. Oxytocin, a neuropeptide known to moderate social behaviors, has been investigated as a potential therapeutic for schizophrenia in recent years. Results have been decidedly mixed, leading to controversy regarding oxytocin's utility. In this review, we outline several considerations for interpreting the extant literature and propose a focused agenda for future work that builds on the most compelling findings regarding oxytocin effects in schizophrenia to date. Specifically, we examine underlying causes of heterogeneity in randomized clinical trials (RCTs) conducted thus far and highlight the complexity of the human oxytocin system. We then review evidence of oxytocin's effects on specific deficits in schizophrenia, arguing for further study using objective, precise outcome measures in order to determine whether oxytocin has the potential to improve functional impairment in schizophrenia.

Keywords: Negative symptoms; Oxytocin; Schizophrenia; Social cognition.

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Conflict of interest statement

Conflict of interest statement: The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1. Relationships between oxytocin effects and antipsychotic dosage
The magnitude of oxytocin-induced changes in high-level social cognition (A), and facial expressivity (B), are significantly associated with lower antipsychotic dosage. Anise odor detection (C) is not significantly associated with lower antipsychotic dosage, although the relationship is in the right direction.
Fig. 2
Fig. 2. Sources of heterogeneity in studies of oxytocin in schizophrenia
Individual factors affect responsiveness to exogenous oxytocin, which, combined with study factors, lead to heterogeneous results.
Fig. 3
Fig. 3. Social cognitive processes in schizophrenia (adapted from Green et al. 2015) and potential oxytocin effects
In studies of oxytocin effects on social cognition in schizophrenia, oxytocin does not consistently influence social cue perception deficits. However, more promising effects are seen on mentalizing deficits. Oxytocin effects on the other domains of social cognition, experience and regulation of emotion and experience sharing, have not yet been investigated.
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