Pituitary volume in individuals at elevated risk for psychosis: A systematic review and meta-analysis

Saunders, Tyler S.; Mondelli, Valeria; Cullen, Alexis E.

doi:10.1016/j.schres.2018.12.026

Cited by 23 publications

(19 citation statements)

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“…The updated model also suggests that the HPA axis interacts with the immuno-inflammatory system (Pruessner et al, 2017). In support of the model, patients with psychosis and those at increased risk for the disorder (due to a family history of illness or clinical features) have been found to show HPA axis abnormalities, including elevated basal and diurnal cortisol, a blunted cortisol awakening response and pituitary volume abnormalities (Berger et al, 2016; Borges, Gayer-Anderson, & Mondelli, 2013; Chaumette et al, 2016; Cullen et al, 2014; Day et al, 2014; Girshkin, Matheson, Shepherd, & Green, 2014; Nordholm et al, 2013; Saunders, Mondelli, & Cullen, 2019). However, a recent meta-analysis of 134 effect sizes from 18 studies (Cullen et al, 2020) found that, in psychosis spectrum groups and healthy controls, psychosocial stressors were only weakly (and not significantly) correlated with cortisol measures.…”

Section: Discussionmentioning

confidence: 99%

Are adult stressful life events associated with psychotic relapse? A systematic review of 23 studies

Martland

Martland²,

Cullen³

et al. 2020

Psychol. Med.

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Relapse rates among individuals with psychotic disorders are high. In addition to the financial burden placed on clinical services, relapse is associated with worse long-term prognosis and poorer quality of life. Robust evidence indicates that stressful life events commonly precede the onset of the first psychotic episode; however, the extent to which they are associated with relapse remains unclear. The aim of this systematic review is to summarize available research investigating the association between recent stressful life events and psychotic relapse or relapse of bipolar disorder if the diagnosis included psychotic symptoms. PsycINFO, Medline and EMBASE were searched for cross-sectional, retrospective and prospective studies published between 01/01/1970 and 08/01/2020 that investigated the association between adult stressful life events and relapse of psychosis. Study quality was assessed using the Effective Public Health Practice Project guidelines. Twenty-three studies met eligibility criteria (prospective studies: 14; retrospective studies: 6; cross-sectional: 3) providing data on 2046 participants in total (sample size range: 14–240 participants). Relapse was defined as a return of psychotic symptoms (n = 20), a return of symptoms requiring hospitalization (n = 2) and a return of symptoms or hospitalization (n = 1). Adult stressful life events were defined as life events occurring after the onset of psychosis. Stressful life events included but were not limited to adult trauma, bereavement, financial problems and conflict. Eighteen studies found a significant positive association between adult stressful life events and psychotic relapse and five studies found a non-significant association. We conclude that adult stressful life events, occurring after psychosis onset, appear to be associated with psychotic relapse.

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Section: Discussionmentioning

confidence: 99%

Are adult stressful life events associated with psychotic relapse? A systematic review of 23 studies

Martland

Martland²,

Cullen³

et al. 2020

Psychol. Med.

Self Cite

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show abstract

“…Still, alterations of PitVol have been reported in multiple psychiatric disorders, with evidence being most abundant in the field of psychosis. Recent metaanalyses have concluded that PitVol is increased among subjects who are at risk for developing psychosis, such as first-degree relatives of affected patients and individuals with Clinical High Risk for psychosis (Nordholm et al, 2013;Saunders et al, 2018). Moreover, increases in PitVol are strongest 5 among individuals who later transition to psychosis (Nordholm et al, 2013;Saunders et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Recent metaanalyses have concluded that PitVol is increased among subjects who are at risk for developing psychosis, such as first-degree relatives of affected patients and individuals with Clinical High Risk for psychosis (Nordholm et al, 2013;Saunders et al, 2018). Moreover, increases in PitVol are strongest 5 among individuals who later transition to psychosis (Nordholm et al, 2013;Saunders et al, 2018). For individuals suffering from a first psychotic episode results point to a milder trend-level increase in PitVol (Nordholm et al, 2013), whereas in later chronic stages of schizophrenia PitVol appears to be reduced (Pariante, 2008).…”

Section: Introductionmentioning

confidence: 99%

Pituitary dysmaturation affects psychopathology and neurodevelopment in 22q11.2 Deletion Syndrome

Sandini

Chambaz

Schneider

et al. 2020

Psychoneuroendocrinology

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“…Abnormalities in cortisol awakening response have been demonstrated in individuals at ultrahigh risk of psychosis [36] and schizophrenia patients as summarized by recent review and meta-analysis showing blunted response when compared to healthy controls [37]. One of early HPA axis alterations in psychosis is pituitary enlargement demonstrated in ultra-high risk individuals, especially those who later develop psychosis [38]. Several studies reported the dysregulation in diurnal cortisol levels, showing elevated diurnal and afternoon levels of cortisol in schizophrenia patients [39].…”

Section: Hpa Axis In Schizophreniamentioning

confidence: 99%

The role of the interaction between the FKBP5 gene and stressful life events in the pathophysiology of schizophrenia: A narrative review

Stramecki¹,

Frydecka²,

Misiak³

2020

Arch Psych Psych

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Stressful life events have been associated with increased risk for development of schizophrenia and play a pivotal role in its psychopathology. Genes related to stress response, such as FKBP5 gene associated with hypothalamic-pituitary-adrenal (HPA) axis, modulate brain response to childhood trauma and determine individual susceptibility for development and course of psychosis. It this review we provide an overview of FKBP5 gene role in human neurophysiology, its association with HPA axis and its role in stress response system in animals and humans. Moreover, we took a closer look on the studies showing the interaction between FKBP5 gene and stressful life events in the pathophysiology of schizophrenia. We explain how interactions between trauma and FKBP5 gene polymorphisms contribute to development of the disease, severity of psychotic symptoms and cognitive disturbances. We also discuss epigenetic modifications that may contribute to altered HPA axis reactivity to stress entailing higher risk for development of psychosis. Considering the pivotal role of FKBP5 gene in physiopathology of schizophrenia we discuss a possible use of new therapeutic agents that may influence HPA axis activity related to the FKBP5 protein especially in individuals exposed to early trauma.

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Pituitary volume in individuals at elevated risk for psychosis: A systematic review and meta-analysis

Cited by 23 publications

References 50 publications

Are adult stressful life events associated with psychotic relapse? A systematic review of 23 studies

Are adult stressful life events associated with psychotic relapse? A systematic review of 23 studies

Pituitary dysmaturation affects psychopathology and neurodevelopment in 22q11.2 Deletion Syndrome

The role of the interaction between the FKBP5 gene and stressful life events in the pathophysiology of schizophrenia: A narrative review

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