title: Impact of stress response in development of first-episode psychosis in schizophrenia: An overview of systematic reviews.
abstract: BACKGROUND
  To summarize all available evidence from systematic reviews about the impact of stress response in development of first-episode psychosis (FEP) in schizophrenia.
  
  
  METHODS
  An overview of systematic reviews of any type of primary studies was performed. An electronic search of five databases was conducted in February 2017 (CDSR, DARE, Embase, MEDLINE and PsychINFO). Quality of included systematic reviews was assessed using the AMSTAR checklist.
  
  
  RESULTS
  Eight systematic reviews were included. The main findings of the included reviews point out a possible alteration of the stress response in a subgroup of persons with proneness to psychosis. However, the evidence is limited by the inadequate quality of studies, as well as lack of standardization of outcomes and assessment methods.
  
  
  CONCLUSIONS
  Given the heterogeneity of current results, there is no solid evidence for uniform alterations of stress response found in persons with FEP in suggestive of schizophrenia that may serve as a marker of vulnerability to stress and possibly proneness to psychotic state in response to daily hassles.
authors.affiliation: Department of Biological Psychiatry, Neuropsychiatric Hospital Dr. Ivan Barbot, Jelengradska 1, 44314 Popovaca, Croatia, lrgajsak@gmail.com.
authors.forename: Linda Rossini
authors.initials: LR
authors.lastname: Gajsak
authors.forename: Andrea
authors.initials: A
authors.lastname: Gelemanovic
authors.forename: Martina Rojnic
authors.initials: MR
authors.lastname: Kuzman
authors.forename: Livia
authors.initials: L
authors.lastname: Puljak
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood*; D001143:Arousal / Q000502:physiology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D012008:Recurrence; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology*; D012565:Schizophrenic Psychology; D013315:Stress, Psychological / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology
chemical_list: D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone