A meta-analysis of blood and salivary cortisol levels in first-episode psychosis and high-risk individuals |
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| Affiliation: | 1. Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland;2. Prevention and Early Intervention Program for Psychosis, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Canada;3. Department of Clinical Psychology, University of Konstanz, Konstanz, Germany;4. Department of Psychiatry, Pomeranian Medical University, Broniewskiego 26 Street, 71-457 Szczecin, Poland;5. VeritaMed Medical Center, Dluga 27 Street, 00-238 Warsaw, Poland;6. Department of Nervous System Diseases, Wroclaw Medical University, Bartla 5 Street, 51-618 Wroclaw, Poland |
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| Abstract: | Dysregulated cortisol responses and glucose metabolism have been reported in psychosis. We performed a random-effects meta-analysis of cortisol responses in first-episode psychosis (FEP) and psychosis risk states, taking into consideration glucose metabolism. A total of 47 studies were included. Unstimulated blood cortisol levels were significantly higher (g = 0.48, 95 %CI: 0.25–0.70, p < 0.001) in FEP, but not in psychosis risk states (g = 0.39, 95 %CI: −0.42–1.21, p = 0.342), compared to controls. Cortisol awakening response (CAR) was attenuated in FEP (g = −0.40, 95 %CI: −0.68 - −0.12, p = 0.006), but not in psychosis risk states (p = 0.433). Glucose and insulin levels were positively correlated with unstimulated blood cortisol levels in FEP. Our meta-analysis supports previous findings of elevated blood cortisol levels and attenuated CAR in FEP. Future research should focus on identifying the common denominators for alterations in stress hormones and glucose metabolism. |
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| Keywords: | HPA axis Schizophrenia Stress Psychosis risk Early intervention |
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