HPA axis in psychotic major depression and schizophrenia spectrum disorders: Cortisol, clinical symptomatology, and cognition
HPA axis in psychotic major depression and schizophrenia spectrum disorders: Cortisol, clinical symptomatology, and cognition
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DOI：
10.1016/j.schres.2019.07.003
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发表时间：
2019-11-01
影响因子：
4.5
通讯作者：
Keller, Jennifer
中科院分区：
文献类型：
--
作者：
Cherian, Kirsten;Schatzberg, Alan F.;Keller, Jennifer
下丘脑-肾上腺（HPA）轴与多种情绪和认知障碍的病理生理学有关。神经内分泌研究表明，HPA轴过度活跃的抑郁症，HPA轴的活动与认知能力的关系，HPA轴的遗传变异在认知中的潜在作用。在精神分裂症中发现了差异性HPA活性，包括对地塞米松激发的非抑制率较高和唾液皮质醇水平较高，这是有发展精神分裂症风险的青少年转化为精神病的先兆风险因素。本研究调查了HPA轴活动和临床病理学在认知能力差中的同时作用。对抑郁症伴精神病（PMD）和精神分裂症谱系障碍（SCZ）患者及健康对照者进行了研究。所有参与者都接受了诊断性访谈和精神病评级，一个全面的神经心理电池，并过夜每小时采血测定皮质醇。临床组之间的认知表现没有差异，尽管他们在各种认知领域的表现都比HC差。在所有受试者中，认知能力与较高的皮质醇呈负相关，PMD患者的夜间皮质醇水平高于SCZ和HC。皮质醇和临床症状，以及年龄，性别和抗精神病药物的使用预测认知能力。素质压力模型和他们的联系，以pharmacology，认知和HPA功能进行了讨论。(C)2019爱思唯尔B. V.保留所有权利。
The Hypothalamic Pituitary Adrenal (HPA) axis has been implicated in the pathophysiology of a variety of mood and cognitive disorders. Neuroendocrine studies have demonstrated HPA axis overactivity in major depression, a relationship of HPA axis activity to cognitive performance, and a potential role of HPA axis genetic variation in cognition. In schizophrenia differential HPA activity has been found, including higher rates of non-suppression to dexamethasone challenge and higher salivary cortisol levels, which have been a premonitory risk factor for conversion to psychosis in adolescents at risk for developing schizophrenia. The present study investigated the simultaneous roles HPA axis activity and clinical symptomatology play in poor cognitive performance. Patients with major depression with psychosis (PMD) or schizophrenia spectrum disorder (SCZ) and healthy controls (HC) were studied. All participants underwent a diagnostic interview and psychiatric ratings, a comprehensive neuropsychological battery, and overnight hourly blood sampling for cortisol. Cognitive performance did not differ between the clinical groups, though they both performed more poorly than the HC's across a variety of cognitive domains. Across all subjects, cognitive performance was negatively correlated with higher cortisol, and PMD patients had higher evening cortisol levels than did SCZ and HCs. Cortisol and clinical symptoms, as well as age, sex, and antipsychotic use predicted cognitive performance. Diathesis stress models and their links to symptomatology, cognition, and HPA function are discussed. (C) 2019 Elsevier B.V. All rights reserved.