Negative symptoms of schizophrenia and the dexamethasone suppression test

Abstract

The dexamethasone suppression test (DST) was administered to 30 inpatients who met the DSM-III-R criteria for chronic schizophrenia and shared similar environments. Four of them (13%) were DST nonsuppressors. The mean and maximum postdexamethasone cortisol levels were correlated with the patient's score on the scale for the Schedule for the Assessment of Negative Symptoms and with the score on the anergia subscale of the Brief Psychiatric Rating Scale. None of the correlations were statistically significant. Furthermore, the scores on the above scales were not significantly correlated with clinical variables such as duration of illness, number of admissions or length of hospitalization, nor were any significant correlations found between the postdexamethasone cortisol levels and the score on the Beck Depression Inventory. In addition, depressed and nondepressed schizophrenics did not differ regarding the rate of nonsuppression and the postdexamethasone cortisol levels. This study found that: 1) dexamethasone nonsuppression in schizophrenia was not related to the presence of negative symptoms; 2) there was no relationship between negative symptoms and illness variables; and 3) the depressed schizophrenics did not display increased nonsuppression compared with nondepressed schizophrenics.

Review: A systematic review of hypothalamic-pituitary-adrenal axis function in schizophrenia: implications for mortality

“…Post-DEX cortisol correlated with negative symptoms following acute treatment detailed in Table 6; however, no clear picture of correlation emerged. Of the 19 studies that looked for a correlation between negative symptoms and non-suppression of post DEX cortisol levels, 10 found a correlation (Altamura et al, 1989;Ceskova et al, 2006;Coppen et al, 1983;Jones et al, 1994;McGauley et al, 1989;Newcomer et al, 1991;Saffer et al, 1985;Tandon et al, 1989Tandon et al, , 1991Tandon et al, , 1996, and nine did not (Aleem et al, 1988;Garyfallos et al, 1993;Harris, 1985;Ismail et al, 1998;Keshavan et al, 1989;Minas et al, 1990;Pivac et al, 1997;Tsoi et al, 1986;Whiteford et al, 1988). Seven studies found a correlation of non-suppression with depression (Addington and Addington, 1990;Hwu et al, 1987;Ismail et al, 1998;Jones et al, 1994;Keshavan et al, 1988;Munro et al, 1984;Sawyer and Jeffries, 1984) while 15 did not (Aleem et al, 1988;Dewan et al, 1982;Doran et al, 1986;Garyfallos et al, 1993;Keshavan et al, 1989;Lu et al, 1988;Minas et al, 1990;Moller et al, 1986;Newcomer et al, 1991;Perenyi et al, 1987;…”

A randomised controlled study of risperidone and olanzapine for schizophrenic patients with neuroleptic-induced acute dystonia or parkinsonism

“…Post-DEX cortisol negatively associated with positive symptomsTandon et al (1991)Recently admitted SCH6/44 (14%) after 4 weeks’ treatment22/58 (38%) at baselinePost-DEX cortisol correlated with negative symptoms but not global severity, positive or depressive symptoms at baseline. No associations at 4 weeksCoryell and Tsuang (1992)Admitted SCH5/20 (25%)––Pandey et al (1992)SCH inpatients11/34 (32%)––Rybakowski and Plocka (1992)SCH inpatients36/105 (34%)–Garyfallos et al (1993)Chronic SCH inpatients4/30 (13%)–No significant correlations of post-DEX cortisol with BPRS, depression or negative symptomsGoldman et al (1993)SCH inpatients (25% polydipsic)7/53 (13%)12/53 (27%)NS was more common in polydipsic patients during treatment with antipsychotics (38% vs. 5%)Jones et al (1994)Hospitalized SCH–12/57 (21%)Post-DEX cortisol correlated with suicide attempt, depression, negative and positive symptoms (BPRS +ve scale 1)Mauri et al (1994)Acutely psychotic SCH inpatients6/24 (25%)–No association of NS with BPRS total…”

“…Of the 19 studies that looked for a correlation between negative symptoms and non-suppression of post DEX cortisol levels, 10 found a correlation (Altamura et al, 1989; Ceskova et al, 2006; Coppen et al, 1983; Jones et al, 1994; McGauley et al, 1989; Newcomer et al, 1991; Saffer et al, 1985; Tandon et al, 1989, 1991, 1996), and nine did not (Aleem et al, 1988; Garyfallos et al, 1993; Harris, 1985; Ismail et al, 1998; Keshavan et al, 1989; Minas et al, 1990; Pivac et al, 1997; Tsoi et al, 1986; Whiteford et al, 1988). …”

“…Seven studies found a correlation of non-suppression with depression (Addington and Addington, 1990; Hwu et al, 1987; Ismail et al, 1998; Jones et al, 1994; Keshavan et al, 1988; Munro et al, 1984; Sawyer and Jeffries, 1984) while 15 did not (Aleem et al, 1988; Dewan et al, 1982; Doran et al, 1986; Garyfallos et al, 1993; Keshavan et al, 1989; Lu et al, 1988; Minas et al, 1990; Moller et al, 1986; Newcomer et al, 1991; Perenyi et al, 1987; Sharma et al, 1988; Tandon et al, 1991, 1996; Tsoi et al, 1986; Whiteford et al, 1988). Goldman et al (1996) found no association of non-suppression with a family history of depression.…”

Συσχέτιση Της Παρούσας Ψυχοπαθολογίας Δείγματος Ελλήνων Ψυχιατρικών Ασθενών Με Τις Συνθήκες Ανατροφής Τους

“…στη Chakos et al, 2005) ενώ μελέτες που προσπάθησαν να διευκρινίσουν τη προέλευση της μείωσης του όγκου δεν κατέληξαν σε ισχυρά συμπεράσματα, υποδεικνύοντας και την έντονη περιβαλλοντική επίδραση(Rijsdijk et al, 2005). Επομένως, σχιζοφρενικοί ασθενείς παρουσιάζουν αυξημένα επίπεδα κορτιζόλης ως απάντηση σε ένα αριθμό διαφόρων βιολογικών προσβολών(Garyfallos et al, 1993), όπως επίσης και σε σωματικό και ψυχολογικό στρες, με πιθανή ανασταλτική επίδραση στις διαδικασίες ανάπτυξης και ωρίμανσης του νευρικού ιστού. Jackson προτείνει ένα διαφορετικό μοντέλο διάκρισης των δύο τύπων της συμπτωματολογίας καθώς, ως αρνητική κλινική ψυχοπαθολογία εννοεί το αποτέλεσμα της διακοπής ή της σημαντικής μείωσης της λειτουργίας ενός οργανωτικού επιπέδου του ΚΝΣ, που προκαλεί με τη σειρά της άρση της ανασταλτικής δράσης του στα κατώτερα επίπεδα και την απώλεια ελέγχου της λειτουργίας τους.…”