Perceived stress and hair cortisol: Differences in bipolar disorder and schizophrenia

Streit, Fabian; Memić, Amra; Hasandedic, Lejla; Rietschel, Liz; Frank, Josef; Lang, Maren; Witt, Stephanie H.; Forstner, Andreas J.; Degenhardt, Franziska; Wüst, Stefan; Nöthen, Markus M.; Kirschbaum, Clemens; Strohmaier, Jana; Oruč, Lilijana; Rietschel, Marcella

doi:10.1016/j.psyneuen.2016.03.010

Cited by 47 publications

(46 citation statements)

References 52 publications

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“…Abnormalities in the hypothalamic–pituitary–adrenal axis, a key mediator of the stress response, have been implicated in both SCZ (84) and BPD (85, 86). Stress hypersensitivity and psychosocial stress increase susceptibility to SCZ (87, 88) and BPD (89, 90) and also exacerbate symptoms in both disorders (91). Index manic (69) and psychotic (92) episodes are often preceded by an increase in stressful life events.…”

Section: Discussionmentioning

confidence: 99%

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

2016

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Early identification and treatment are associated with improved outcomes in bipolar disorder (BPD) and schizophrenia (SCZ). Screening for the presence of these disorders usually involves time-intensive interviews that may not be practical in settings where mental health providers are limited. Thus, individuals at earlier stages of illness are often not identified. The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) screen is a self-report questionnaire originally developed to identify clinical risk for developing bipolar or psychotic disorders. The goal of the current study was to investigate the utility of the WERCAP Screen and two complementary questionnaires, the WERC Stress Screen and the WERC Substance Screen, in identifying individuals with established SCZ or BPD. Participants consisted of 35 BPD and 34 SCZ patients, as well as 32 controls (CON), aged 18–30 years. Univariate analyses were used to test for score differences between groups. Logistic regression and receiver operating characteristic (ROC) curves were used to identify diagnostic predictors. Significant group differences were found for the psychosis section of the WERCAP (pWERCAP; p < 0.001), affective section of the WERCAP (aWERCAP; p = 0.001), and stress severity (p = 0.027). No significant group differences were found in the rates of substance use as measured by the WERC Substance Screen (p = 0.267). Only the aWERCAP and pWERCAP scores were useful predictors of diagnostic category. ROC curve analysis showed the optimal cut point on the aWERCAP to identify BPD among our participant groups was a score of >20 [area under the curve (AUC): 0.87; sensitivity: 0.91; specificity: 0.71], while that for the pWERCAP to identify SCZ was a score of >13 (AUC: 0.89; sensitivity: 0.88; specificity: 0.82). These results indicate that the WERCAP Screen may be useful in screening individuals for BPD and SCZ and that identifying stress and substance-use severity can be rapidly done using self-report questionnaires. Larger studies in undiagnosed individuals will be needed to test the WERCAP Screen’s ability to identify mania or psychosis in the community.

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Section: Discussionmentioning

confidence: 99%

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

2016

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“…Studies on the CAR in FEP patients found either no association with symptoms (Mondelli et al, 2010a, Pruessner et al, 2013b or only a trend level relationship between cortisol levels and poor global functioning (Pruessner et al, 2015b). As a measure of cortisol changes over time, hair cortisol concentrations (HCC) over the past three months correlate with general psychopathology (Andrade et al, 2016) and HCC at the time of admission can differentiate between in-and outpatients with psychosis (Streit et al, 2016).…”

Section: Cortisol and Psychotic Symptoms And Syndromesmentioning

confidence: 99%

“…In contrast, a recent study of CHR subjects failed to show an association between transition to psychosis and cortisol levels measured at the time of recruitment, however some were on antipsychotics (Chaumette et al, 2016). Two recent studies employing hair cortisol showed that elevations in basal HPA axis activity precede the onset of psychosis (Andrade et al, 2016) and mark an acute illness course as opposed to remission (Streit et al, 2016).…”

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confidence: 99%

The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities

Pruessner

Cullen

Aas

et al. 2017

Neuroscience & Biobehavioral Reviews

249

178

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. (2017). The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neuroscience and biobehavioral reviews, 73, 191-218. https://doi.org/10. 1016/j.neubiorev.2016.12.013 Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim.

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“…HCC was also similar for schizophrenia and bipolar disorder patients. Conversely, Streit et al (2016) found that HCC was higher in bipolar disorder compared to schizophrenia. Staufenbiel and Koenders (2014) and Manenschijn et al (2012) both found that HCC was not associated with bipolar disorder.…”

Section: Introductionmentioning

confidence: 93%

“…Staufenbiel and Koenders (2014) and Manenschijn et al (2012) both found that HCC was not associated with bipolar disorder. Only Streit et al (2016) and Coello et al (2019) found that HCC was higher in bipolar patients compared with healthy individuals. However, when hair cortisol data have meta-analytically been integrated, results have not shown the presence of an association between HCC alterations and mood disorders (Stalder et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Cortisol levels in unmedicated patients with unipolar and bipolar major depression using hair and saliva specimens

Herane-Vives

Arnone

Angel

et al. 2020

Int J Bipolar Disord

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Background: Differentiating between unipolar and bipolar depression can be clinically challenging, especially at first presentation. Patterns of cortisol secretion could aid diagnostic discrimination in affective disorders although there has been little comparative research to date. In this study, we investigated acute (saliva) and chronic (hair) cortisol levels concurrently in unmedicated unipolar and bipolar disorders by using conventional diagnostic criteria and selfreport measures. Methods: Patients with unipolar and bipolar major depression and healthy controls were recruited and assessed. Cortisol levels were extracted from saliva and hair specimens. Depressive features were investigated according to diagnostic groups and with a continuous self-report measure of bipolarity using the Hypomania Checklist (HCL-33). Results: Whilst a trend towards a reduction in the total daily salivary cortisol output-area under the curve with respect to the ground (AUCg)-was detected in depressive disorders across diagnosis, the self-administrated bipolarity index suggested that an increase in bipolarity symptoms predicted lower cortisol levels using AUCg. Chronic cortisol measurement did not discriminate unipolar from bipolar depression. Conclusion: Results suggested that whilst a low total daily salivary cortisol output (AUCg) might be associated with depressive symptoms, a self-reported measure of bipolarity predicts lower daily cortisol output.

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Perceived stress and hair cortisol: Differences in bipolar disorder and schizophrenia

Cited by 47 publications

References 52 publications

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

Utility of Washington Early Recognition Center Self-Report Screening Questionnaires in the Assessment of Patients with Schizophrenia and Bipolar Disorder

The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities

Cortisol levels in unmedicated patients with unipolar and bipolar major depression using hair and saliva specimens

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