title: Stress and HPA-axis functioning in young people at ultra high risk for psychosis.
abstract: It is thought that hypothalamic-pituitary-adrenal (HPA) axis functioning mediates between the experience of stress and development of psychotic symptoms. This study aimed to evaluate this model in a cohort of young people at ultra high risk (UHR) of psychosis. Information about the experience of psychological symptoms and recent stressful experiences was obtained from 23 young people who met UHR criteria. Plasma samples were taken to assess cortisol and glucocorticoid receptor numbers, and an MRI scan was also performed. Plasma cortisol levels were significantly and positively correlated with the experience of 'hassles' but not with the experience of stressful life events. Significant positive associations were also found between plasma cortisol levels and level of depression and anxiety. No significant relationships were found between plasma cortisol level and global psychopathology, psychotic symptomatology, functioning or pituitary and hippocampal volumes. These results suggest that the number of hassles experienced by young people at UHR of psychosis could be an important factor in raising their cortisol levels, which might, in turn, affect the severity of depressive and anxiety symptoms. No other relationships were found between plasma cortisol levels and the experience of psychotic symptoms, functioning or hippocampal and pituitary volumes. These results indicate possible impairment in HPA-axis functioning in the early stages of psychotic illness, but further investigation of the relationships between these parameters is required.
authors.affiliation: PACE Clinic/Orygen Research Centre, Locked Bag 10, Parkville 3052, Australia.
authors.forename: K N
authors.initials: KN
authors.lastname: Thompson
authors.forename: L J
authors.initials: LJ
authors.lastname: Phillips
authors.forename: P
authors.initials: P
authors.lastname: Komesaroff
authors.forename: H P
authors.initials: HP
authors.lastname: Yuen
authors.forename: S J
authors.initials: SJ
authors.lastname: Wood
authors.forename: C
authors.initials: C
authors.lastname: Pantelis
authors.forename: D
authors.initials: D
authors.lastname: Velakoulis
authors.forename: A R
authors.initials: AR
authors.lastname: Yung
authors.forename: P D
authors.initials: PD
authors.lastname: McGorry
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D001921:Brain / Q000473:pathology; D010054:Brief Psychiatric Rating Scale / Q000706:statistics & numerical data; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D008297:Male; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis / Q000235:genetics* / Q000503:physiopathology; D011965:Receptors, Glucocorticoid / Q000097:blood; D012306:Risk; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology; D014739:Victoria
chemical_list: D011965:Receptors, Glucocorticoid; D006854:Hydrocortisone