TY - JOUR
T1 - Stress biomarkers as predictors of transition to psychosis in at-risk mental states
T2 - roles for cortisol, prolactin and albumin
AU - Labad, Javier
AU - Stojanovic-Pérez, Alexander
AU - Montalvo, Itziar
AU - Solé, Montse
AU - Cabezas, Ángel
AU - Ortega, Laura
AU - Moreno, Irene
AU - Vilella, Elisabet
AU - Martorell, Lourdes
AU - Reynolds, Rebecca M
AU - Gutiérrez-Zotes, Alfonso
N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.
PY - 2015/1
Y1 - 2015/1
N2 - Stress and inflammation are thought to play a role in the risk of developing a psychotic disorder. We aimed to identify stress-related biomarkers for psychosis transition in help-seeking individuals with an at-risk mental state (ARMS). We studied 39 ARMS subjects who were attending an Early Intervention Service. We included a control group of 44 healthy subjects (HS) matched by sex and age. Stressful life events and perceived stress were assessed. Stress-related biomarkers were determined in serum (cortisol, prolactin, C-reactive protein and albumin), plasma (fibrinogen) or saliva (morning cortisol, cortisol awakening response). All ARMS were followed-up at our Unit for at least one year. We divided the ARMS group into two subgroups based on the development of a psychotic disorder (ARMS-P, N = 10) or not (ARMS-NP, N = 29). ARMS-P reported more stressful life events and perceived stress than HS and ARMS-NP groups. In relation to baseline stress biomarkers, ARMS-P subjects had increased prolactin and lower albumin levels in serum, when compared to ARMS-NP and HS groups. These results did not change when repeated in a subsample of antipsychotic-naïve ARMS subjects. We also found significant differences between groups in the cortisol secretion after awakening. In a multinomial logistic regression adjusting for age, sex and life stress, prolactin was a predictor of psychosis transition whereas albumin levels had a protective effect. Our study underscores the role of stress and stress-related biomarkers (cortisol awakening response, prolactin and albumin) in the pathogenesis of psychosis.
AB - Stress and inflammation are thought to play a role in the risk of developing a psychotic disorder. We aimed to identify stress-related biomarkers for psychosis transition in help-seeking individuals with an at-risk mental state (ARMS). We studied 39 ARMS subjects who were attending an Early Intervention Service. We included a control group of 44 healthy subjects (HS) matched by sex and age. Stressful life events and perceived stress were assessed. Stress-related biomarkers were determined in serum (cortisol, prolactin, C-reactive protein and albumin), plasma (fibrinogen) or saliva (morning cortisol, cortisol awakening response). All ARMS were followed-up at our Unit for at least one year. We divided the ARMS group into two subgroups based on the development of a psychotic disorder (ARMS-P, N = 10) or not (ARMS-NP, N = 29). ARMS-P reported more stressful life events and perceived stress than HS and ARMS-NP groups. In relation to baseline stress biomarkers, ARMS-P subjects had increased prolactin and lower albumin levels in serum, when compared to ARMS-NP and HS groups. These results did not change when repeated in a subsample of antipsychotic-naïve ARMS subjects. We also found significant differences between groups in the cortisol secretion after awakening. In a multinomial logistic regression adjusting for age, sex and life stress, prolactin was a predictor of psychosis transition whereas albumin levels had a protective effect. Our study underscores the role of stress and stress-related biomarkers (cortisol awakening response, prolactin and albumin) in the pathogenesis of psychosis.
KW - Adult
KW - Biological Markers
KW - C-Reactive Protein
KW - Case-Control Studies
KW - Female
KW - Humans
KW - Hydrocortisone
KW - Hypothalamo-Hypophyseal System
KW - Male
KW - Pituitary-Adrenal System
KW - Prolactin
KW - Psychotic Disorders
KW - Risk Factors
KW - Saliva
KW - Serum Albumin
KW - Young Adult
U2 - 10.1016/j.jpsychires.2014.10.011
DO - 10.1016/j.jpsychires.2014.10.011
M3 - Article
C2 - 25466832
SN - 0022-3956
VL - 60
SP - 163
EP - 169
JO - Journal of Psychiatric Research
JF - Journal of Psychiatric Research
ER -