Relation between self-perceived stress, psychopathological symptoms and the stress hormone prolactin in emerging psychosis

Studerus, Erich; Ittig, Sarah; Beck, Katharina; Cacho, N. Del; Vila‐Badia, Regina; Butjosa, Anna; Usall, Judith; Riecher‐Rössler, Anita

doi:10.1016/j.jpsychires.2020.06.014

Cited by 22 publications

(15 citation statements)

References 55 publications

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“…Results in the search of hyperprolactinemia as a marker of psychosis have been conflicting. The levels of serum prolactin were found to be elevated [22], not dissimilar [23], or even reduced in women compared to men [27] in the included studies; hence the need for greater personalization when taking care of patients with psychosis. Another such issue regards the immune system, which like the endocrine and the nervous systems regards cell-cell communication and uses similar mechanisms to carry out its functions.…”

Section: Resultsmentioning

confidence: 86%

“…It could be speculated that stress, which can induce hyperprolactinemia, has a stronger effect on women than on men in emerging psychosis [21,22]. Recently, central nervous system autoimmunity has been implicated in the etiology of psychosis, with specific gender differences [23]. It has been suggested that prolactin may underlie the excess of morbidity and early mortality in naïve patients with a first episode of psychosis through a specific pathway that intertwines inflammatory, immune and metabolic trajectories [24].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Psychosis in Women: Time for Personalized Treatment

Mazza

Caroppo

Berardis

et al. 2021

JPM

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Early detection and prompt treatment of psychosis is of the utmost importance. The great variability in clinical onset, illness course, and response to pharmacological and psychosocial treatment is in great part gender-related. Our aim has been to review narratively the literature focusing on gender related differences in the psychoses, i.e., schizophrenia spectrum disorders. We searched the PubMed/Medline, Scopus, Embase, and ScienceDirect databases on 31 July 2021, focusing on recent research regarding sex differences in early psychosis. Although women, compared to men, tend to have better overall functioning at psychotic symptom onset, they often present with more mood symptoms, may undergo misdiagnosis and delay in treatment and are at a higher risk for antipsychotic drug-induced metabolic and endocrine-induced side effects. Furthermore, women with schizophrenia spectrum disorders have more than double the odds of having physical comorbidities than men. Tailored treatment plans delivered by healthcare services should consider gender differences in patients with a diagnosis of psychosis, with a particular attention to early phases of disease in the context of the staging model of psychosis onset.

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Section: Resultsmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Psychosis in Women: Time for Personalized Treatment

Mazza

Caroppo

Berardis

et al. 2021

JPM

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“…Altered plasma oxytocin and prolactin levels have been described in patients suffering psychiatric disorders ( Beckmann et al, 1985 ; Goldman et al, 2008 ; Cochran et al, 2013 ; Petrikis et al, 2016 ; Delgado-Alvarado et al, 2019 ; Strauss et al, 2019 ; Studerus et al, 2021 ), although the association of these alterations with the neuropsychiatric and clinical characteristics of an FEP are not well understood. Oxytocin is a hormone mainly synthesized in the supraoptic and paraventricular nuclei of the hypothalamus, nuclei with projections to other brain areas where this hormone acts as a neurotransmitter ( Jurek and Neumann, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, prolactin is involved in several central nervous system functions, such as the regulation of stress, energy balance, anxiety, neurogenesis, food intake, and maternal behavior ( Patil et al, 2014 ). Patients with schizophrenia frequently have elevated levels of prolactin as a consequence of pharmacological treatment, although an increase in prolactin has also been demonstrated in untreated psychiatric patients ( Garcia-Rizo et al, 2012 ; Riecher-Rössler et al, 2013 ; Petrikis et al, 2016 ; Delgado-Alvarado et al, 2019 ; Pisk et al, 2019 ; Studerus et al, 2021 ). The elevation of prolactin is lower when second-generation antipsychotics, such as ziprasidone, clozapine, olanzapine, aripiprazole, or quetiapine, are used ( Kane et al, 1981 ; Beasley et al, 1996 ; Daniel and Copeland, 2000 ; Crespo-Facorro et al, 2017 ; Wadoo et al, 2017 ); however, other antipsychotics, such as paliperidone or risperidone, do increase prolactin levels ( Berwaerts et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

The Influence of Oxytocin and Prolactin During a First Episode of Psychosis: The Implication of Sex Differences, Clinical Features, and Cognitive Performance

Hidalgo-Figueroa

Salazar

Romero-López-Alberca

et al. 2022

International Journal of Neuropsychopharmacology

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Background Around 3% of the population suffers a first episode of psychosis (FEP) and a high percentage of these patients subsequently relapse. As the clinical course following a FEP is hard to predict, it is of interest to identify cognitive and biological markers that will help improve the diagnosis, treatment and outcome of such events, and to define new therapeutic targets. Here we analyzed the plasma oxytocin and prolactin levels during a FEP, assessing their correlation with clinical and cognitive features. Methods The oxytocin and prolactin in plasma was measured in 120 FEP patients and 106 healthy controls, all of whom were subjected to a clinical and neuropsychological assessment. Most patients were under antipsychotics. Statistical analyses aimed to identify factors associated with the FEP and to search for associations between the variables. Results FEP patients had less oxytocin, more prolactin, a poor premorbid-IQ and they performed worse in sustained attention. Male patients with higher prolactin levels experienced more severe psychotic symptoms and required higher doses of antipsychotics. Low oxytocin was associated with poor sustained attention in women, whereas low oxytocin and high prolactin in men correlated with better performance in sustained attention. Conclusion Low oxytocin, high prolactin, and poor premorbid-IQ and sustained attention are factors associated with a FEP, representing potential therapeutic targets in these patients. These biological factors and cognitive domains might play an important role during a FEP, which could help us to develop new strategies that improve the outcomes of this disorder and that should perhaps be gender specific.

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“…Heightened stress response, as measured by perceived stress scale (PSS), preceded the onset of psychosis in both schizophrenia patients [5] and rodents [6]. Patients of rst episode psychosis also showed higher PSS scores along with affective or psychotic symptoms than healthy controls (HCs) [5,7].…”

Section: Introductionmentioning

confidence: 99%

CSF1R Contributes to Vascular Association of Microglia and Stress Regulation in Schizophrenia

Tian

Liu²,

Li³

et al. 2022

Preprint

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Whether and how microglia contribute to stress and anxiety in schizophrenia are not well established. We hypothesized that microglial colony stimulating factor 1 receptor (CSF1R) regulates stress susceptibility in schizophrenia via the hippocampus and associated cortical regions. A cohort of first-episode schizophrenia (FES) patients (n=51) and age- and sex-paired healthy controls (HCs) (n=46) were first recruited. Compared to HCs, FES patients showed higher scores of perceived stress scale (PSS, p<0.01), lower levels of CSF1R mRNA (Log2FC=-0.195, FDR=0.003) and protein (18.31±0.95 vs. 20.49±0.90 µg/ml, p<0.05) in the blood, and smaller volumes of the superiorfrontal gyrus (39.13±0.64 vs. 40.80±0.76 cm3, FDR<0.05) and parahippocampal gyrus (3.51±0.048 vs. 3.72±0.058 cm3, FDR<0.05). CSF1R facilitated the negative superiorfrontal gyral association with PSS (β=6.109, 95% CI: 1.642~10.578, p<0.01) in HCs but not FES patients. CSF1R-associated gene network contributed to brain development. We further studied a chronic unpredictable stress (CUS) mouse model combined with a CSF1R inhibitor (CSF1Ri). Both CUS and CSF1Ri enhanced anxiety in mice (both p<0.001). RNA-seq revealed downregulation of genes for cell adhesion and angiogenesis after CUS-CSF1Ri treatment. Immunostaining showed downregulation of CD31 and preferential loss of vessel-associated IBA1+-microglia induced by CUS or CSF1Ri (p<0.05). Oligodendrocyte precursor cells were however increased after CUS-CSF1Ri treatment (p<0.01). These results suggest that microglial CSF1R showed a protective effect on stress and anxiety in FES patients and CUS mice via contribution to angiogenesis.

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Relation between self-perceived stress, psychopathological symptoms and the stress hormone prolactin in emerging psychosis

Cited by 22 publications

References 55 publications

Psychosis in Women: Time for Personalized Treatment

Psychosis in Women: Time for Personalized Treatment

The Influence of Oxytocin and Prolactin During a First Episode of Psychosis: The Implication of Sex Differences, Clinical Features, and Cognitive Performance

CSF1R Contributes to Vascular Association of Microglia and Stress Regulation in Schizophrenia

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