title: Pituitary gland volume and psychosocial stress among children at elevated risk for schizophrenia.
abstract: BACKGROUND
  Pituitary volume enlargements have been observed among individuals with first-episode psychosis. These abnormalities are suggestive of hypothalamic-pituitary-adrenal (HPA) axis hyperactivity, which may contribute to the development of psychosis. However, the extent to which these abnormalities characterize individuals at elevated risk for schizophrenia prior to illness onset is currently unclear, as volume increases, decreases and no volume differences have all been reported relative to controls. The current study aimed to determine whether antipsychotic-naive, putatively at-risk children who present multiple antecedents of schizophrenia (ASz) or a family history of illness (FHx) show pituitary volume abnormalities relative to typically developing (TD) children. An additional aim was to explore the association between pituitary volume and experiences of psychosocial stress.
  
  
  METHODS
  ASz (n = 30), FHx (n = 22) and TD (n = 32) children were identified at age 9-12 years using a novel community-screening procedure or as relatives of individuals with schizophrenia. Measures of pituitary volume and psychosocial stress were obtained at age 11-14 years.
  
  
  RESULTS
  Neither ASz nor FHx children showed differences in pituitary volume relative to TD children. Among FHx children only, pituitary volume was negatively associated with current distress relating to negative life events and exposure to physical punishment.
  
  
  CONCLUSIONS
  The lack of pituitary volume abnormalities among ASz and FHx children is consistent with our previous work demonstrating that these children are not characterized by elevated diurnal cortisol levels. The findings imply that these biological markers of HPA axis hyperactivity, observed in some older samples of high-risk individuals, may emerge later, more proximally to disease onset.
authors.affiliation: Department of Forensic and Neurodevelopmental Sciences,Institute of Psychiatry,Psychology & Neuroscience,King's College London,London,UK.
authors.forename: A E
authors.initials: AE
authors.lastname: Cullen
authors.affiliation: Health Service and Population Research,Institute of Psychiatry,Psychology & Neuroscience,King's College London,London,UK.
authors.forename: F L
authors.initials: FL
authors.lastname: Day
authors.affiliation: Department of Forensic and Neurodevelopmental Sciences,Institute of Psychiatry,Psychology & Neuroscience,King's College London,London,UK.
authors.forename: R E
authors.initials: RE
authors.lastname: Roberts
authors.affiliation: Section of Stress,Psychiatry and Immunology and Perinatal Psychiatry,Department of Psychological Medicine,Institute of Psychiatry,Psychology & Neuroscience,King's College London,London,UK.
authors.forename: C M
authors.initials: CM
authors.lastname: Pariante
authors.affiliation: Department of Forensic and Neurodevelopmental Sciences,Institute of Psychiatry,Psychology & Neuroscience,King's College London,London,UK.
authors.forename: K R
authors.initials: KR
authors.lastname: Laurens
mesh_terms: D002648:Child; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008016:Life Change Events; D008297:Male; D010902:Pituitary Gland / Q000473:pathology*; D011678:Punishment; D012306:Risk; D012559:Schizophrenia / Q000473:pathology*; D013315:Stress, Psychological / Q000209:etiology / Q000473:pathology*
keywords: Childhood trauma; diathesis–stress model; genetic high risk; hypothalamic–pituitary–adrenal axis; psychosis vulnerability