Cortisol Levels and Risk for Psychosis: Initial Findings from the North American Prodrome Longitudinal Study
Cortisol Levels and Risk for Psychosis: Initial Findings from the North American Prodrome Longitudinal Study
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DOI：
10.1016/j.biopsych.2013.02.016
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发表时间：
2013-09-15
影响因子：
10.6
通讯作者：
Woods, Scott W.
中科院分区：
文献类型：
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作者：
Walker, Elaine F.;Trotman, Hanan D.;Woods, Scott W.
背景：对下丘脑-垂体-肾上腺活动生物标志物的研究表明，精神障碍与皮质醇升高有关。这项研究检查了健康对照受试者和符合精神病临床高风险 (CHR) 标准的个体的皮质醇水平。据推测，CHR 组的皮质醇水平会 1) 相对于对照组受试者升高，2) 与症状严重程度呈正相关，3) 在转变为精神病级别严重程度的 CHR 患者中皮质醇水平最高。 方法：在北美前驱症状纵向研究的八个中心进行基线评估。目前的 CHR 样本包括 256 名符合前驱症状量表标准的个体和 141 名对照受试者，所有这些受试者都接受了唾液皮质醇的基线评估和测量。 结果：与之前的报告一致，年龄对皮质醇有影响，在青少年/成年早期，皮质醇会有所增加。协方差分析显示诊断组的主效应，CHR 组显示出较高的皮质醇。皮质醇与基线症状严重程度存在适度的正相关性，协方差分析显示，与健康对照受试者和缓解的 CHR 受试者相比，那些转变为精神病水平症状的受试者的基线皮质醇较高。 结论：目前的研究结果进一步证明了 CHR 个体皮质醇分泌增加的证据。研究结果还表明皮质醇水平与症状严重程度以及症状进展之间存在非特异性关联。下丘脑-垂体-肾上腺活动在预测精神病转化中的作用及其与其他风险生物标志物的关系应在未来的研究中受到关注。
Background: Studies of biomarkers of hypothalamic-pituitary-adrenal activity indicate that psychotic disorders are associated with elevated cortisol. This study examined cortisol levels in healthy control subjects and individuals who met clinical high-risk (CHR) criteria for psychosis. It was hypothesized that cortisol levels would be 1) elevated in the CHR group relative to control subjects, 2) positively correlated with symptom severity, and 3) most elevated in CHR patients who transition to psychotic level severity.Methods: Baseline assessments were conducted at eight centers in the North American Prodrome Longitudinal Study. The present CHR sample included 256 individuals meeting the Scale for Prodromal Symptoms criteria and 141 control subjects, all of whom underwent baseline assessment and measurement of salivary cortisol.Results: Consistent with previous reports, there was an effect of age on cortisol, with increases through the adolescent/early adult years. Analysis of covariance showed a main effect of diagnostic group, with the CHR group showing higher cortisol. There were modest, positive correlations of cortisol with baseline symptom severity, and analysis of covariance revealed higher baseline cortisol in those who transitioned to psychotic level symptoms when compared with healthy control subjects and CHR subjects who remitted.Conclusions: The present findings add to accumulating evidence of heightened cortisol secretion in CHR individuals. The findings also indicate nonspecific associations between cortisol levels and symptom severity, as well as symptom progression. The role of hypothalamic-pituitary-adrenal activity in prediction of conversion to psychosis and its relation with other biomarkers of risk should receive attention in future research.