Cortisol Responses to Naturally Occurring Psychosocial Stressors Across the Psychosis Spectrum: A Systematic Review and Meta-Analysis

Cullen, Alexis E.; Rai, Sushma; Vaghani, Meghna S.; Mondelli, Valeria; McGuire, Philip

doi:10.3389/fpsyt.2020.00513

Cited by 14 publications

(20 citation statements)

References 76 publications

(189 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nonetheless, only scarce research has found an association between early adversity, life events or perceived stress and hair cortisol, and the direction of the associations has been contradictory among studies. Cullen and colleagues ( 62 ) reviewed studies examining the concordance between psychosocial stressors and cortisol measures in healthy controls, individuals at clinical high-risk for psychosis and with clinical psychosis, and only weak correlations were found. The present study complements the studies reviewed ( 62 ) by focusing on non-clinical individuals with psychometric high risk, although more research on the psychoendocrine covariance across the psychosis continuum is needed.…”

Section: Discussionmentioning

confidence: 99%

“…Shapero and colleagues ( 26 ) did not find any association between HCC and number of life events, whereas Xu's ( 27 ) and Karlén's ( 61 ) studies reported a positive association and Sierau's ( 31 ) a negative one. Finally, Cullen and colleagues ( 62 ) reviewed the literature examining the concordance between naturally-occurring psychosocial stressors, both distal (trauma) and proximal (perceived stress and life events), with cortisol across clinical and at-risk psychosis populations. Although all types of cortisol measurements were included in the meta-analysis, a poor correlation [ r = 0.05 (95% CI: −0.00 to 0.10), p = 0.059] was found between stressors and cortisol measures (including HCC).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Examining the Relationship Between Hair Cortisol With Stress-Related and Transdiagnostic Subclinical Measures

Torrecilla

Barrantes‐Vidal

2021

Front. Psychiatry

View full text Add to dashboard Cite

Background: Hair cortisol concentrations (HCC) provide a retrospective examination of long-term cortisol production as a measure of the hypothalamic-pituitary-adrenal (HPA) axis functioning, one of the major neural systems implicated in mediating the effects of stress on mental illness. However, evidence about the relationship between HCC with stressors and symptoms is scattered. In the present study, we aimed to examine the association between HCC and a wide range of stress-related and transdiagnostic subclinical measures in a sample of non-clinical young adults with a wide distribution of schizotypy.Methods: A total sample of 132 non-clinical young adults recruited at college and technical schools oversampled for schizotypy scores were assessed on distal and proximal stressful experiences, appraisals of stress, traits and symptoms of the affective, psychosis and dissociation spectrums, as well as stress-buffering measures, and provided 3 cm-hair samples.Results: No significant associations were found between HCC and any of the stress-related and subclinical measures. Only suspiciousness and disorganization showed a trend for a positive association with HCC but the magnitude was small.Conclusions: The present findings support previous studies indicating an overall lack of concordance between a broad range of stress-related and (sub)clinical phenotypic measures with hair cortisol. This study examined for the first time the relationship of HCC with the non-clinical expression of the psychosis spectrum, that is, schizotypy, which complements previous studies on clinical high risk and established psychosis and offers a promising strategy for studying possible HPA dysfunctions characterizing the subclinical psychosis continuum without the confounds associated to clinical psychosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Examining the Relationship Between Hair Cortisol With Stress-Related and Transdiagnostic Subclinical Measures

Torrecilla

Barrantes‐Vidal

2021

Front. Psychiatry

View full text Add to dashboard Cite

show abstract

“…In support of the model, patients with psychosis and those at increased risk for the disorder (due to a family history of illness or clinical features) have been found to show HPA axis abnormalities, including elevated basal and diurnal cortisol, a blunted cortisol awakening response and pituitary volume abnormalities (Berger et al, 2016; Borges, Gayer-Anderson, & Mondelli, 2013; Chaumette et al, 2016; Cullen et al, 2014; Day et al, 2014; Girshkin, Matheson, Shepherd, & Green, 2014; Nordholm et al, 2013; Saunders, Mondelli, & Cullen, 2019). However, a recent meta-analysis of 134 effect sizes from 18 studies (Cullen et al, 2020) found that, in psychosis spectrum groups and healthy controls, psychosocial stressors were only weakly (and not significantly) correlated with cortisol measures. Whilst these findings imply that the HPA abnormalities characterising psychosis spectrum groups are not driven by psychosocial stressors, the authors identified a range of methodological issues that may have obscured the ability to detect significant associations.…”

Section: Discussionmentioning

confidence: 99%

Are adult stressful life events associated with psychotic relapse? A systematic review of 23 studies

Martland

Martland²,

Cullen³

et al. 2020

Psychol. Med.

Self Cite

View full text Add to dashboard Cite

Relapse rates among individuals with psychotic disorders are high. In addition to the financial burden placed on clinical services, relapse is associated with worse long-term prognosis and poorer quality of life. Robust evidence indicates that stressful life events commonly precede the onset of the first psychotic episode; however, the extent to which they are associated with relapse remains unclear. The aim of this systematic review is to summarize available research investigating the association between recent stressful life events and psychotic relapse or relapse of bipolar disorder if the diagnosis included psychotic symptoms. PsycINFO, Medline and EMBASE were searched for cross-sectional, retrospective and prospective studies published between 01/01/1970 and 08/01/2020 that investigated the association between adult stressful life events and relapse of psychosis. Study quality was assessed using the Effective Public Health Practice Project guidelines. Twenty-three studies met eligibility criteria (prospective studies: 14; retrospective studies: 6; cross-sectional: 3) providing data on 2046 participants in total (sample size range: 14–240 participants). Relapse was defined as a return of psychotic symptoms (n = 20), a return of symptoms requiring hospitalization (n = 2) and a return of symptoms or hospitalization (n = 1). Adult stressful life events were defined as life events occurring after the onset of psychosis. Stressful life events included but were not limited to adult trauma, bereavement, financial problems and conflict. Eighteen studies found a significant positive association between adult stressful life events and psychotic relapse and five studies found a non-significant association. We conclude that adult stressful life events, occurring after psychosis onset, appear to be associated with psychotic relapse.

show abstract

“…A recent meta-analysis demonstrated poor concordance between naturally-occurring stressors and the HPA axis dysfunction in patients with psychosis [19]. Apart from certain methodological considerations, it should be noted that exposure to ACEs is not a risk factor specifically associated with the psychosis spectrum.…”

Section: Introductionmentioning

confidence: 99%

Adverse Childhood Experiences and Methylation of the FKBP5 Gene in Patients with Psychotic Disorders

Misiak

Karpiński

Szmida

et al. 2020

JCM

View full text Add to dashboard Cite

Altered methylation of the FKBP5 gene has been observed in various mental disorders and attributed to the effects of adverse childhood experiences (ACEs). However, the level of FKBP5 methylation has not been investigated in patients with psychotic disorders. Therefore, in this study we aimed to determine the FKBP5 methylation in patients with psychosis and controls, taking into account the effects of ACEs. Participants were 85 patients with psychotic disorders, including first-episode psychosis (FEP) patients and acutely relapsed schizophrenia (SCZ-AR) patients, as well as 56 controls. The level of four CpG sites at the FKBP5 gene was determined in the peripheral blood leukocytes using pyrosequencing. After controlling for potential confounding factors, the level of FKBP5 methylation at one out of four tested CpG sites was significantly lower in FEP patients compared to other groups of participants. Significant main effects of parental antipathy and sexual abuse on the level of FKBP5 methylation were observed at the differentially methylated CpG site. Participants reporting this category of ACEs had significantly lower levels of FKBP5 methylation at this CpG site. Lower levels of FKBP5 methylation were associated with better cognitive performance and higher functional capacity in patients with psychosis. In controls, lower methylation of FKBP5 was related to worse performance of immediate memory and language skills. Our findings suggest that hypomethylation of the FKBP5 appears at early stages of psychosis and might be associated with a history of ACEs as well as less severe clinical manifestation.

show abstract

Cortisol Responses to Naturally Occurring Psychosocial Stressors Across the Psychosis Spectrum: A Systematic Review and Meta-Analysis

Cited by 14 publications

References 76 publications

Examining the Relationship Between Hair Cortisol With Stress-Related and Transdiagnostic Subclinical Measures

Examining the Relationship Between Hair Cortisol With Stress-Related and Transdiagnostic Subclinical Measures

Are adult stressful life events associated with psychotic relapse? A systematic review of 23 studies

Adverse Childhood Experiences and Methylation of the FKBP5 Gene in Patients with Psychotic Disorders

Contact Info

Product

Resources

About