Daniel B Hubbard1, Brian J Miller2. 1. Medical College of Georgia, Augusta University, Augusta, GA, United States. 2. Department of Psychiatry and Health Behavior, Augusta University, 997 Saint Sebastian Way, Augusta, GA, 30912, United States. Electronic address: brmiller@augusta.edu.
Abstract
OBJECTIVE: Schizophrenia is associated with abnormal neuroimmunoendocrine function. There is evidence for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in individuals with first-episode psychosis (FEP). However, some previous meta-analyses have focused on heterogeneous sample sources and patient populations. We performed a meta-analysis of baseline (i.e., one sample) blood cortisol levels in individuals with FEP and minimal exposure to antipsychotics. METHOD: Articles were identified by searching PubMed, PsycInfo, Web of Science, and Science Direct, and the reference lists of these studies. RESULTS: Twenty-six studies (comprising twenty-seven samples) met the inclusion criteria. Blood cortisol levels were significantly increased in individuals with FEP compared to controls with a small-to-medium effect size (standard mean difference [SMD] = 0.37, 95% CI 0.16-0.57, p < 0.001). In meta-regression analyses, geography was a significant moderator of this association, with larger effects seen in studies conducted in Asia versus the Middle East. CONCLUSION: We found elevated blood cortisol levels in individuals with FEP, providing additional, complementary evidence for abnormal HPA axis function in this disorder. This finding, which does not inform on mechanism, is consistent with the "neural diathesis-stress" model of psychosis. Given the immunomodulatory effects of cortisol, methodologically rigorous longitudinal studies of cortisol parameters, inflammatory markers, and psychopathology in this patient population are warranted.
OBJECTIVE:Schizophrenia is associated with abnormal neuroimmunoendocrine function. There is evidence for hypothalamic-pituitary-adrenal (HPA) axis abnormalities in individuals with first-episode psychosis (FEP). However, some previous meta-analyses have focused on heterogeneous sample sources and patient populations. We performed a meta-analysis of baseline (i.e., one sample) blood cortisol levels in individuals with FEP and minimal exposure to antipsychotics. METHOD: Articles were identified by searching PubMed, PsycInfo, Web of Science, and Science Direct, and the reference lists of these studies. RESULTS: Twenty-six studies (comprising twenty-seven samples) met the inclusion criteria. Blood cortisol levels were significantly increased in individuals with FEP compared to controls with a small-to-medium effect size (standard mean difference [SMD] = 0.37, 95% CI 0.16-0.57, p < 0.001). In meta-regression analyses, geography was a significant moderator of this association, with larger effects seen in studies conducted in Asia versus the Middle East. CONCLUSION: We found elevated blood cortisol levels in individuals with FEP, providing additional, complementary evidence for abnormal HPA axis function in this disorder. This finding, which does not inform on mechanism, is consistent with the "neural diathesis-stress" model of psychosis. Given the immunomodulatory effects of cortisol, methodologically rigorous longitudinal studies of cortisol parameters, inflammatory markers, and psychopathology in this patient population are warranted.
Authors: Filip Stramecki; Dorota Frydecka; Łukasz Gawęda; Katarzyna Prochwicz; Joanna Kłosowska; Jerzy Samochowiec; Krzysztof Szczygieł; Edyta Pawlak; Elżbieta Szmida; Paweł Skiba; Andrzej Cechnicki; Błażej Misiak Journal: Brain Sci Date: 2021-04-28
Authors: Anastasiia S Boiko; Irina A Mednova; Elena G Kornetova; Nikolay A Bokhan; Arkadiy V Semke; Anton J M Loonen; Svetlana A Ivanova Journal: Neuropsychiatr Dis Treat Date: 2020-04-22 Impact factor: 2.570
Authors: Alexis E Cullen; Helen L Fisher; Nancy Gullet; Elizabeth R Fraser; Ruth E Roberts; Uzma Zahid; Melody To; Natalie Huijing Yap; Patricia A Zunszain; Carmine M Pariante; Stephen J Wood; Philip McGuire; Robin M Murray; Valeria Mondelli; Kristin R Laurens Journal: Biol Psychiatry Date: 2021-08-19 Impact factor: 12.810
Authors: Alexis E Cullen; Jean Addington; Carrie E Bearden; William S Stone; Larry J Seidman; Kristin S Cadenhead; Tyrone D Cannon; Barbara A Cornblatt; Daniel H Mathalon; Thomas H McGlashan; Diana O Perkins; Ming T Tsuang; Scott W Woods; Elaine F Walker Journal: Psychoneuroendocrinology Date: 2020-03-07 Impact factor: 4.905