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Article: Abnormal cortisol awakening response predicts worse cognitive function in patients with first-episode psychosis

TitleAbnormal cortisol awakening response predicts worse cognitive function in patients with first-episode psychosis
Authors
KeywordsCognition
cortisol
hypothalamic-pituitary-adrenal (HPA) axis
psychosis
schizophrenia
stress
Issue Date2011
PublisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSM
Citation
Psychological Medicine, 2011, v. 41 n. 3, p. 463-476 How to Cite?
AbstractBackground Cognitive impairment, particularly in memory and executive function, is a core feature of psychosis. Moreover, psychosis is characterized by a more prominent history of stress exposure, and by dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. In turn, stress exposure and abnormal levels of the main HPA axis hormone cortisol are associated with cognitive impairments in a variety of clinical and experimental samples; however, this association has never been examined in first-episode psychosis (FEP).Method In this study, 30 FEP patients and 26 controls completed assessment of the HPA axis (cortisol awakening response and cortisol levels during the day), perceived stress, recent life events, history of childhood trauma, and cognitive function. The neuropsychological battery comprised general cognitive function, verbal and non-verbal memory, executive function, perception, visuospatial abilities, processing speed, and general knowledge.Results Patients performed significantly worse on all cognitive domains compared to controls. In patients only, a more blunted cortisol awakening response (that is, more abnormal) was associated with a more severe deficit in verbal memory and processing speed. In controls only, higher levels of perceived stress and more recent life events were associated with a worse performance in executive function and perception and visuospatial abilities.Conclusions These data support a role for the HPA axis, as measured by cortisol awakening response, in modulating cognitive function in patients with psychosis; however, this association does not seem to be related to the increased exposure to psychosocial stressors described in these patients. © 2010 Cambridge University Press.
Persistent Identifierhttp://hdl.handle.net/10722/141821
ISSN
2015 Impact Factor: 5.491
2015 SCImago Journal Rankings: 2.843
PubMed Central ID
ISI Accession Number ID
Funding AgencyGrant Number
British Academy
South London
Maudsley NHS Foundation Trust
Institute of Psychiatry National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health
National Alliance for Research on Schizophrenia and Depression (NARSAD)
BIAL Foundation
KCL Translational Research Grant
King's College Development Trust (UK)
American Psychiatric Institute for Research and Education (APIRE)
UK Medical Research Council
Commission of European Communities22963
Funding Information:

This specific aspect of the study was funded by a grant from the British Academy to C. M. Pariante. The study was also supported by the South London and Maudsley NHS Foundation Trust and the Institute of Psychiatry National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health; by a National Alliance for Research on Schizophrenia and Depression (NARSAD) Young Investigator Award, a grant from the BIAL Foundation, and a KCL Translational Research Grant, to P. Dazzan; by a King's College Development Trust (UK) Studentship, and a NARSAD Young Investigator Award, to V. Mondelli; and by additional funding to C. M. Pariante from the American Psychiatric Institute for Research and Education (APIRE), the NARSAD, the UK Medical Research Council, and the Commission of European Communities 7th Framework Programme Collaborative Project Grant Agreement no. 22963 (Mood Inflame). Finally, we thank the GAP researchers who helped with the data collection, and the patients who took part in the study.

References

 

DC FieldValueLanguage
dc.contributor.authorAas, Men_HK
dc.contributor.authorDazzan, Pen_HK
dc.contributor.authorMondelli, Ven_HK
dc.contributor.authorToulopoulou, Ten_HK
dc.contributor.authorReichenberg, Aen_HK
dc.contributor.authorDi Forti, Men_HK
dc.contributor.authorFisher, HLen_HK
dc.contributor.authorHandley, Ren_HK
dc.contributor.authorHepgul, Nen_HK
dc.contributor.authorMarques, Ten_HK
dc.contributor.authorMiorelli, Aen_HK
dc.contributor.authorTaylor, Hen_HK
dc.contributor.authorRusso, Men_HK
dc.contributor.authorWiffen, Ben_HK
dc.contributor.authorPapadopoulos, Aen_HK
dc.contributor.authorAitchison, KJen_HK
dc.contributor.authorMorgan, Cen_HK
dc.contributor.authorMurray, RMen_HK
dc.contributor.authorPariante, CMen_HK
dc.date.accessioned2011-09-27T03:02:36Z-
dc.date.available2011-09-27T03:02:36Z-
dc.date.issued2011en_HK
dc.identifier.citationPsychological Medicine, 2011, v. 41 n. 3, p. 463-476en_HK
dc.identifier.issn0033-2917en_HK
dc.identifier.urihttp://hdl.handle.net/10722/141821-
dc.description.abstractBackground Cognitive impairment, particularly in memory and executive function, is a core feature of psychosis. Moreover, psychosis is characterized by a more prominent history of stress exposure, and by dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. In turn, stress exposure and abnormal levels of the main HPA axis hormone cortisol are associated with cognitive impairments in a variety of clinical and experimental samples; however, this association has never been examined in first-episode psychosis (FEP).Method In this study, 30 FEP patients and 26 controls completed assessment of the HPA axis (cortisol awakening response and cortisol levels during the day), perceived stress, recent life events, history of childhood trauma, and cognitive function. The neuropsychological battery comprised general cognitive function, verbal and non-verbal memory, executive function, perception, visuospatial abilities, processing speed, and general knowledge.Results Patients performed significantly worse on all cognitive domains compared to controls. In patients only, a more blunted cortisol awakening response (that is, more abnormal) was associated with a more severe deficit in verbal memory and processing speed. In controls only, higher levels of perceived stress and more recent life events were associated with a worse performance in executive function and perception and visuospatial abilities.Conclusions These data support a role for the HPA axis, as measured by cortisol awakening response, in modulating cognitive function in patients with psychosis; however, this association does not seem to be related to the increased exposure to psychosocial stressors described in these patients. © 2010 Cambridge University Press.en_HK
dc.languageengen_US
dc.publisherCambridge University Press. The Journal's web site is located at http://journals.cambridge.org/action/displayJournal?jid=PSMen_HK
dc.relation.ispartofPsychological Medicineen_HK
dc.subjectCognitionen_HK
dc.subjectcortisolen_HK
dc.subjecthypothalamic-pituitary-adrenal (HPA) axisen_HK
dc.subjectpsychosisen_HK
dc.subjectschizophreniaen_HK
dc.subjectstressen_HK
dc.titleAbnormal cortisol awakening response predicts worse cognitive function in patients with first-episode psychosisen_HK
dc.typeArticleen_HK
dc.identifier.emailToulopoulou, T:timothea@hku.hken_HK
dc.identifier.authorityToulopoulou, T=rp01542en_HK
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1017/S0033291710001170en_HK
dc.identifier.pmid20529412-
dc.identifier.pmcidPMC3513413-
dc.identifier.scopuseid_2-s2.0-79956314856en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79956314856&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume41en_HK
dc.identifier.issue3en_HK
dc.identifier.spage463en_HK
dc.identifier.epage476en_HK
dc.identifier.eissn1469-8978-
dc.identifier.isiWOS:000287622100003-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridAas, M=34869082200en_HK
dc.identifier.scopusauthoridDazzan, P=6602196376en_HK
dc.identifier.scopusauthoridMondelli, V=15073211100en_HK
dc.identifier.scopusauthoridToulopoulou, T=8855468700en_HK
dc.identifier.scopusauthoridReichenberg, A=6603720193en_HK
dc.identifier.scopusauthoridDi Forti, M=10738849300en_HK
dc.identifier.scopusauthoridFisher, HL=9235818300en_HK
dc.identifier.scopusauthoridHandley, R=35237429500en_HK
dc.identifier.scopusauthoridHepgul, N=34869590400en_HK
dc.identifier.scopusauthoridMarques, T=32367791400en_HK
dc.identifier.scopusauthoridMiorelli, A=24829604000en_HK
dc.identifier.scopusauthoridTaylor, H=39262485600en_HK
dc.identifier.scopusauthoridRusso, M=35764063200en_HK
dc.identifier.scopusauthoridWiffen, B=34882315100en_HK
dc.identifier.scopusauthoridPapadopoulos, A=7101944753en_HK
dc.identifier.scopusauthoridAitchison, KJ=7003415672en_HK
dc.identifier.scopusauthoridMorgan, C=8559399400en_HK
dc.identifier.scopusauthoridMurray, RM=35406239400en_HK
dc.identifier.scopusauthoridPariante, CM=7003615668en_HK

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