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

Abstract

. (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.

The relationship between cannabis use and cortisol levels in youth at ultra high-risk for psychosis

“…This is the first study to examine the relationship between cannabis use and HPA axis dysfunction in UHR individuals and the current results add to the understanding of potential environmental and biological risk factors of psychosis (Pruessner et al, 2017; Walker et al, 2008). There is currently much debate and uncertainty around the causal role that cannabis use may play in the development of psychotic disorders (Buchy et al, 2015).…”

Dandy-Walker Malformation-Like Condition Revealed by Refractory Schizophrenia: A Case Report and Literature Review

“…Cannabis use may also contribute to or precipitate the onset of the illness and can predict adverse outcomes, including higher relapse rates, longer hospital admissions, more severe positive symptoms, and treatment resistance [89]. This illustrates the diathesis-stress-support model of schizophrenia in which biogenetic and psychosocial factors interact in a vulnerability-stress model [90-92]. Therefore, organicity, specifically DWM-like in this case, and cannabis use do not prevent the establishment of a schizophrenia diagnosis.…”

Theranostic Biomarkers for Schizophrenia

“…Stress, which modifies the HPA function, has been strongly implicated in the etiology of schizophrenia [8]. The neural-diathesis stress model of schizophrenia hypothesizes that schizophrenia develops as a consequence of the HPA axis dysregulation, and that different neurotransmitters and neuroimmune factors, neuroanatomical structures, pathways and connectivity, and genetic, epigenetic, neurodevelopmental and environmental factors modulate the main stress system (i.e., HPA axis activity) in vulnerable subjects exposed to stress [9,10,11]. …”

“…DST non-suppression ranges from 0 to 81% [70]. In addition, HPA abnormalities are documented also by the findings showing glucocorticoid receptor downregulation associated with altered and reduced HPA axis system negative feedback mechanism, and increased cortisol secretion frequently related to reduced hippocampal volume in schizophrenia [10,11]. …”

“…Therefore, abnormal response of the HPA axis in schizophrenia is present, but cortisol is affected by numerous factors, such as body fluid (saliva or blood), time of sampling, stage of the illness, various symptoms, antipsychotic medication and stress induced by psychological and other environmental stressors [66,70]. Besides these factors, cortisol is under the influence of development and age [11]. Therefore, components of the HPA axis such as moderately increased cortisol, non-suppression to DST, altered diurnal rhythm of cortisol, and blunted or altered cortisol response to physiological stressors might be used as neuroendocrine diagnostic biomarkers of patients with schizophrenia, but should be compared to either drug-naïve patients or patients with a first episode of psychosis [70].…”