Stress biomarkers as predictors of transition to psychosis in at-risk mental states: roles for cortisol, prolactin and albumin

Javier Labad, Alexander Stojanovic-Pérez, Itziar Montalvo, Montse Solé, Ángel Cabezas, Laura Ortega, Irene Moreno, Elisabet Vilella, Lourdes Martorell, Rebecca M Reynolds, Alfonso Gutiérrez-Zotes

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

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.

Original languageEnglish
Pages (from-to)163-9
Number of pages7
JournalJournal of Psychiatric Research
Publication statusPublished - Jan 2015

Keywords / Materials (for Non-textual outputs)

  • Adult
  • Biological Markers
  • C-Reactive Protein
  • Case-Control Studies
  • Female
  • Humans
  • Hydrocortisone
  • Hypothalamo-Hypophyseal System
  • Male
  • Pituitary-Adrenal System
  • Prolactin
  • Psychotic Disorders
  • Risk Factors
  • Saliva
  • Serum Albumin
  • Young Adult


Dive into the research topics of 'Stress biomarkers as predictors of transition to psychosis in at-risk mental states: roles for cortisol, prolactin and albumin'. Together they form a unique fingerprint.

Cite this