Hypothalamic-Pituitary-Adrenal Axis Function in Chronic Schizophrenia: Association with Clinical Features

Abstract

The function of the hypothalamic-pituitary-adrenal axis (HPA-axis) and its association with clinical features in chronic schizophrenia were investigated. Twenty of 33 chronic schizophrenics exhibited an abnormal diurnal variation of the saliva cortisol level. The patients with abnormal diurnal variation gave higher scores for some negative symptoms than those with normal diurnal variation. On the dexamethasone suppression test (DST) of saliva samples, 13 of 34 chronic schizophrenics were abnormal. The patients with DST nonsuppression were more frequently classified into disorganized type and exhibited low scores of anxiety compared with the patients with normal suppression. The 9 patients who showed abnormal diurnal variation and DST nonsuppression were more frequently classified into disorganized type and showed higher scores of negative symptoms than the 9 patients who did not show any abnormal cortisol data. These results suggest that there might be some disturbance in the function of the HPA-axis in a group of chronic schizophrenics and that these patients might have severe negative symptoms.

Serum Cortisol and DHEA-S Levels in Schizophrenic Patients with Different Response to Antipsychotic Therapy: Association with Psychopathology / Серумски Концентрации На Кортизол И DHEA-S Кал Пациенти Со Шизофренша Со Различен Одговор На Антипсихотичната Терапша Асоци.1Аци.1А Со Психопатологшата

“…Our study showed that plasma cortisol levels were significantly elevated in the group of patients with schizophrenia compared with controls, which is in agreement with the results of most of the studies [2][3][4][5][6][7][8][9]. However there arestudies reporting no significant differences between the schizophrenic patients and healthy controls in terms of cortisol levels [10,29], as well as lower cortisol levels in patients with schizophrenia [11].…”

“…Authors of some previous studies found positive correlation between cortisol levelsand negative symptoms [7,17,26,30]. In contrast, some other studies found a correlation between serum cortisol and positive symptoms [2,5,25,31]. It has been suggested that the relation between cortisol levels and symptom severityis due to the augmenting effects of cortisol on dopamine activity [27].…”

“…The neuroendocrinological system, particularly the HPA axis, has been a focus of interest for neurobiological studies aiming at elucidating the cause of schizophrenia [2]. HPA axis abnormalities may cause an increase in the baseline cortisol level [3].…”

“…HPA axis abnormalities may cause an increase in the baseline cortisol level [3]. It has been demonstrated that serum baseline cortisol levels are increased in patients with schizophrenia [2][3][4][5][6][7][8][9]. However there are also other studies with contrary findings [10][11].…”

“…In some studies cortisol secretion was primarily associated with more severe positive symptoms [2,5,25], whereas in others it was associated with higher ratings of negative symptoms [7,17,26]. It has been suggested that the relation between cortisol levels and symptoms severity is due to the augmenting effects of cortisol on dopamine activity [27].…”