title: Hypothalamic-pituitary-adrenal axis measures and cognitive abilities in early psychosis: Are there sex differences?
abstract: Measures of hypothalamic-pituitary-adrenal (HPA) axis activity such as increased diurnal cortisol levels or a blunted cortisol awakening response (CAR) have been associated with cognitive impairments in people with psychotic disorders. We aimed to explore whether there are sex differences in the relationship between HPA axis measures and cognition in early psychosis (EP).
  
  
  
  60 EP outpatients and 50 healthy subjects (HS) were assessed with the MATRICS Consensus Cognitive Battery. Saliva cortisol levels were determined at the neuropsychological assessment and on another day at 6 sampling times: awakening; 30' and 60' post-awakening; and 10:00h, 23:00h and 10:00h the day after the administration of 0.25mg of dexamethasone, which occurred at 23:00h. Three HPA axis measures were calculated: CAR, cortisol diurnal slope and cortisol suppression ratio of the dexamethasone suppression test (DST). Multiple linear regression analyses were conducted to explore the relationship between HPA axis measures and cognitive tasks while adjusting for covariates (education level, smoking, cannabis use, and cortisol levels at the cognitive assessment). Interactions between female sex, EP diagnosis and HPA axis measures were examined.
  
  
  
  An increased CAR was associated with a poorer cognitive performance in EP women in processing speed and verbal memory. In contrast, a more flattened diurnal cortisol slope was associated with poorer functioning in the spatial working memory of EP women. DST suppression ratio was associated with better visual memory, without sex differences.
  
  
  
  Our study suggests that there are sex differences in the relationship between HPA axis measures and cognitive abilities in EP.
authors.affiliation: Corporació Sanitària Parc Taulí, I3PT, Universitat Autònoma de Barcelona. CIBERSAM, Sabadell, Spain. Electronic address: Jlabad@tauli.cat.
authors.forename: Javier
authors.initials: J
authors.lastname: Labad
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Gutiérrez-Zotes
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Creus
authors.affiliation: Corporació Sanitària Parc Taulí, I3PT, Universitat Autònoma de Barcelona. CIBERSAM, Sabadell, Spain.
authors.forename: Itziar
authors.initials: I
authors.lastname: Montalvo
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Cabezas
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: Solé
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Ortega
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Algora
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Sánchez-Gistau
authors.affiliation: Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili. CIBERSAM, Reus, Spain.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Vilella
mesh_terms: D000293:Adolescent; D000328:Adult; D060825:Cognitive Dysfunction / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism*; D008297:Male; D010913:Pituitary-Adrenal System / Q000378:metabolism*; D011618:Psychotic Disorders / Q000150:complications / Q000378:metabolism*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D006854:Hydrocortisone
keywords: Cognition; Cortisol; Early psychosis; Gender differences; Hypothalamic-pituitary-adrenal axis; Sex differences