| Summary: | Statement of the problem : Stressful life events have been shown to have great influence on the onset or recurrence of psychotic symptoms [1]. Increased stressful life events [2], perceived stress [3], and higher cortisol levels [4,5] have been described in subjects with a first psychotic episode. The main aim of our study was to explore the relationship between stress measures and cortisol levels in subjects with early psychoses. Methods : We included 85 subjects, aged between 18 and 35 years, who attended the Early Psychosis Program from Reus (Tarragona, Spain). All subjects were assessed at baseline using a structured clinical interview (Schedules for Clinical Assessment in Neuropsychiatry) to obtain a clinical diagnosis. We stratified the sample into three groups: Group 1, first episode of psychosis (FEP, N = 36); Group 2, critical period (CP, defined as a psychotic disorder >1 year of duration of illness, N=35); and Group 3, ultra high risk (UHR, subjects with prodromal psychotic symptoms, N=14). Perceived stress was assessed with perceived stress scale (PSS). Stressful life events during the previous 6 months were assessed with the Holmes Rahe Social Readjustment Scale. A fasting morning blood sample (9 h) was obtained to determine total cortisol in plasma. SPSS v.17.0 was used for the statistical analyses. Spearman correlations were used to explore the association between continuous variables. Wilcoxon test was used to compare continuous variables between diagnostic groups. A p-value <0.05 was considered significant. Results : In all subjects, stressful life events were positively associated with perceived stress (r=0.244, p=0.033) but not with plasma cortisol levels. In the stratified analysis by diagnoses, no significant differences in stressful life events were found between all three groups. Subjects at risk for psychosis (UHR) reported greater scores in PSS (30.6±11.7) than other groups (FEP: 27.0±0.1; CP: 20.9), this result being statistically significant (p=0.003). Those subjects from the critical period group showed increased plasma cortisol (20.7±4.8) when compared to UHR (18.9±6.4) and FEP (18.12±4.5) groups. Conclusion : UHR subjects report greater levels of perceived stress when compared to those subjects with a psychotic disorder. Stressful life events and perceived stress are associated but not with plasma cortisol levels.
|
|---|
