title: HPA axis response to social stress is attenuated in schizophrenia but normal in depression: evidence from a meta-analysis of existing studies.
abstract: We conducted a meta-analysis to investigate the HPA axis response to social stress in studies that used the Trier Social Stress Test (TSST), or comparable distressing paradigms, in individuals with either depression or schizophrenia. Sample size-adjusted effect sizes (Hedge's g statistic) were calculated to estimate the HPA axis stress response to social stress. We used a meta-regression model to take into account the moderating effect of the baseline cortisol level. Participants with depression show an activation pattern to social stress similar to that of healthy controls. Despite a normal cortisol production rate, individuals with schizophrenia have lower cortisol levels than controls both in anticipation and after exposure to social stress. Participants with depression and higher cortisol levels before the task have an increased cortisol production and reached higher cortisol levels during the task. This may be explained by the presence of an impaired negative feedback. The activation pattern present in schizophrenia may explain the reduced ability to appropriately contextualize past experiences shown by individuals with psychosis in social stressful situation.
authors.affiliation: King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, 16 De Crespigny Park, London SE5 8AF, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, London, UK. Electronic address: simone.ciufolini@kcl.ac.uk.
authors.forename: Simone
authors.initials: S
authors.lastname: Ciufolini
authors.affiliation: King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, 16 De Crespigny Park, London SE5 8AF, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, London, UK.
authors.forename: Paola
authors.initials: P
authors.lastname: Dazzan
authors.affiliation: King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, 16 De Crespigny Park, London SE5 8AF, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kempton
authors.affiliation: King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Crespigny Park, London SE5 8AF, UK.
authors.forename: Carmine
authors.initials: C
authors.lastname: Pariante
authors.affiliation: National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King's College London, London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, Crespigny Park, London SE5 8AF, UK.
authors.forename: Valeria
authors.initials: V
authors.lastname: Mondelli
mesh_terms: D000293:Adolescent; D000328:Adult; D003866:Depressive Disorder / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012559:Schizophrenia / Q000503:physiopathology*; D013315:Stress, Psychological / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Cortisol; Cortisol negative feedback; Depression; HPA axis reactivity; Memory; Psychosis; Schizophrenia; Social stress