title: Sex-specific cortisol levels in bipolar disorder and schizophrenia during mental challenge--relationship to clinical characteristics and medication.
abstract: OBJECTIVE
  Our objective was to examine the cortisol release during a mental challenge in severe mental disorders versus healthy controls (HC), analyzing effects of sex, clinical characteristics and medication, and comparing Bipolar Disorder (BD) to Schizophrenia (SCZ).
  
  
  METHODS
  Patients with BD and SCZ (n=151) were recruited from a catchment area. HC (n=98) were randomly selected from the same area. Salivary samples were collected before and after a mental challenge and cortisol levels determined.
  
  
  RESULTS
  During the challenge there was an interaction between group and sex (P = 0.015) with male patients having a blunted cortisol release compared to male HC (P = 0.037). Cortisol change did not differ significantly between BD and SCZ. In all patients, the cortisol change correlated with number of psychotic episodes (r = -0.23, P = 0.025), and in females patients, with number of depressive episodes (r = -0.33, P = 0.015). Patients using antidepressants had a greater cortisol release during challenge than those not using antidepressants (P = 0.043).
  
  
  CONCLUSIONS
  Male patients with severe mental disorders seem to have a uniform abnormal cortisol release during mental challenges which associates with clinical course, and with beneficial effects of antidepressants.
authors.affiliation: Psychosis Research Unit, Division of Mental Health and Addiction, Oslo University Hospital, Ullevål Hospital, P.O. Box 4956 Nydalen, 0424 Oslo, Norway. n.e.steen@medisin.uio.no
authors.forename: Nils Eiel
authors.initials: NE
authors.lastname: Steen
authors.forename: Steinar
authors.initials: S
authors.lastname: Lorentzen
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Barrett
authors.forename: Trine V
authors.initials: TV
authors.lastname: Lagerberg
authors.forename: Sigrun
authors.initials: S
authors.lastname: Hope
authors.forename: Sara
authors.initials: S
authors.lastname: Larsson
authors.forename: Akiah O
authors.initials: AO
authors.lastname: Berg
authors.forename: Ingrid
authors.initials: I
authors.lastname: Agartz
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.forename: Jens P
authors.initials: JP
authors.lastname: Berg
authors.forename: Ole A
authors.initials: OA
authors.lastname: Andreassen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000378:metabolism; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000097:blood* / Q000188:drug therapy / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D008297:Male; D008568:Memory / Q000502:physiology; D008570:Memory, Short-Term / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011863:Radioimmunoassay; D012463:Saliva / Q000737:chemistry / Q000378:metabolism; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012727:Sex Characteristics; D014796:Visual Perception / Q000502:physiology; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D006854:Hydrocortisone