Hypothalamic-Pituitary-Adrenal (HPA) Axis Functioning among Patients with Schizophrenia: A Cross Sectional Comparative Study
- *Corresponding Author:
- Mamta Singh
Department of Biochemistry
Mahatma Gandhi Medical College and Hospital
RIICO Institutional Area
Sitapura, Jaipur, India-302022
E-mail: [email protected]
Received Date: May 24, 2014; Accepted Date: November 25, 2014; Published Date: December 3, 2014
Citation: Singh M, Solanki RK, Bagaria B, Swami MK (2015) Hypothalamic-Pituitary-Adrenal (HPA) Axis Functioning among Patients with Schizophrenia: A Cross Sectional Comparative Study. J Psychiatry 18:211. doi: 10.4172/Psychiatry.1000211
Copyright: © 2015, Mamta Singh et al., This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objectives: Higher perceived stress and maladaptive coping strategies seems to play an important role in the course and outcome of schizophrenia. The biological effects of stress are mediated by the hypothalamic-pituitary-adrenal (HPA) axis functioning (reflected by cortisol and DHEAS ratio). The aim of this study were, first to compare serum cortisol, DHEA-S concentration and their molar ratio in schizophrenic patients with healthy subjects, and secondly to determine their correlation with psychopathology of schizophrenia. Methods: One hundred clinically established male patients with schizophrenia and fifty ages matched healthy controls participated in this study. Fasting serum cortisol and DHEAS levels were measured by Chemiluminescence Immunoassay (CLIA). Psychopathology was assessed by using the Positive and Negative Syndrome Scale (PANSS). Sociodemographic characteristics, data regarding onset of illness, disease duration and medication history were recorded in self designed semi-structured proforma. The data collected on above tools, were analyzed by z test and Pearson Correlation Coefficient. Results: Serum cortisol levels and cortisol to DHEAS molar ratio were significantly higher in schizophrenic patients [(z=-4.457; p<0.001) (z=-3.787; p<0.001)] than in healthy comparison subjects, while no significant differences were seen in the DHEAS levels. These hormonal indices were not significantly associated with severity of psychopathology, onset of illness and disease duration in schizophrenia patients. Conclusions: Our findings suggest that besides the elevated cortisol level, cortisol to DHEAS ratio might reflect abnormal HPA axis functions in schizophrenic patients. Persistent stress vulnerability in these patients may lead to increased sensitivity to brain insults and in turn dysregulated neurotransmission, resulting in progressive deterioration in cognitive, emotional and psychosocial functions.