Plasma cortisol-dehydroepiandrosterone (DHEA) ratios in schizophrenia and bipolar disorder.
Hypercortisolaemia is a feature of many severe psychiatric illnesses and has been suggested to be both a causal and exacerbating factor of clinical symptoms and neurocognitive impairment. The adrenal steroid dehydroepiandrosterone (DHEA) has antiglucocorticoid properties that may have regulatory effects on glucocorticoid action in the brain. However, there is a paucity of data on these steroids and their ratio in schizophrenia and bipolar disorder. We therefore sought to assess cortisol and DHEA levels and the cortisol-DHEA ratio in patients with schizophrenia (n=20) and bipolar disorder (n=20), on stable medication for a minimum of 6 weeks, and healthy age- and sex-matched control subjects (n=20). Steroid levels were measured from plasma samples collected at 30 min intervals from 1:00 p.m. to 4:00 p.m. Cortisol levels were found to be significantly elevated in both patient groups compared with controls. DHEA levels were elevated in schizophrenic patients compared with bipolar patients and controls, but there was no evidence of a difference in the cortisol-DHEA ratio of the groups. These data suggest that afternoon hypercortisolaemia is evident in symptomatic bipolar and schizophrenic patients compared to controls. However, an elevation in DHEA levels may represent a specific endocrine marker in schizophrenia.
Gallagher
Peter
P
School of Neurology, Neurobiology and Psychiatry, Newcastle University, UK. peter.gallagher@newcastle.ac.uk
Watson
Stuart
S
Smith
Margaret S
MS
Young
Allan H
AH
Ferrier
I Nicol
IN
D000328:Adult; D000367:Age Factors; D000928:Antidepressive Agents / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D010054:Brief Psychiatric Rating Scale; D002940:Circadian Rhythm / Q000502:physiology; D003480:Cushing Syndrome / Q000097:blood; D003687:Dehydroepiandrosterone / Q000097:blood*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy
D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents; D015415:Biomarkers; D003687:Dehydroepiandrosterone; D006854:Hydrocortisone