Plasma cortisol levels and illness appraisal in deficit syndrome schizophrenia

Does social defeat cause negative symptoms? A prospective study in a multi-national community sample

Psychological models of the consequences of ostracism (i.e. being socially excluded and ignored) and negative symptoms in schizophrenia suggest that repeatedly experiencing ostracism can lead to elevated levels of amotivation, anhedonia, and asociality (i.e. negative symptoms). We tested this assumption in a prospective study, following up a large multi-national community sample from Germany, Indonesia, and the United States (N = 962) every four months over one year. At each of the four assessment points (T0 - T3), participants rated their recent ostracism experiences and negative symptoms. Using cross-lagged panel analyses we found a) that negative symptoms and experiences of ostracism were significantly associated in each of the four assessment points, b) that ostracism predicted negative symptoms over time (T2 to T3), and c) that negative symptoms increased ostracism (T0 to T1). The results are in line with the social defeat model of negative symptoms and suggest a bi-directional longitudinal relationship between ostracism and negative symptoms. Moving forward, it will therefore be important to gain an understanding of potential moderators involved in the mechanism.

Deficit syndrome in Chinese patients with first-episode drug naïve schizophrenia: Prevalence, demographic and clinical characteristics

BACKGROUND

Deficit syndrome (DS) is a common subgroup of schizophrenia. However, few studies have examined the prevalence and risk factors for DS in Chinese Han patients with schizophrenia. The aim of this study was to assess prevalence, demographic and clinical characteristics of DS in Chinese Han patients with first-episode drug naïve (FEDN) schizophrenia.

METHODS

In total, 235 patients with schizophrenia were recruited, and clinical and demographic data were collected. The Positive and Negative Syndrome Scale (PANSS) was utilized for the psychopathological symptoms, and the 17-item Hamilton Depression Rating Scale (HDRS-17) for depressive symptoms. The Proxy for the Deficit Syndrome (PDS) was adopted to identify DS.

RESULTS

The prevalence of DS in the cohort of first-episode schizophrenia patients was 23.0%. Compared to those patients without DS, patients with DS had younger age, lower education level, and were more likely to be single. Further, DS patients had significantly lower scores of positive symptoms, general psychopathology, and depression than non-DS patients. Patients with DS had fewer suicide attempts, but they had more severe negative symptoms and cognitive impairment (all p < 0.05). Multiple regression showed that poor cognitive functioning, lower levels of depression and younger age at onset were predictors of DS.

CONCLUSIONS

Chinese Han patients with FEDN schizophrenia have high prevalence of DS. Some demographic and clinical parameters may be associated with DS.

Chronic phencyclidine treatment impairs spatial working memory in rhesus monkeys

RATIONALE

Phencyclidine (PCP) could induce schizophrenia (Sz) like behavior in both humans and animals, therefore, has been widely utilized to establish Sz animal models. It induced cognitive deficits, the core symptom of Sz, mainly through influencing frontal dopaminergic function. Nonhuman primate (NHP) studies demonstrated impaired object retrieval detour (ORD) and spatial delayed response (SDR) task performance by acute or chronic PCP treatment. However, NHP investigations, continually monitoring SDR performance before, during and after PCP treatment, are lacking.

OBJECTIVES

Present study investigated the long-term influence of chronic PCP treatment on SDR performance and the possible increase of SDR deficit severity and duration by the incremental dosing procedure in rhesus monkeys.

METHODS

SDR task was performed repeatedly up to eight weeks after constant dosing procedure (i.m., 0.3 mg/kg, day 12-25), during which drug effects on locomotor activity and blood cortisol concentration were assessed. Incremental dosing procedure (starting dose 0.3 mg/kg, day 6-19) began five months later.

RESULTS

Constant dosing procedure induced differential level of hyperactivity across testing days, without significant influence on blood cortisol concentration. It reduced SDR performance, until occurrence of the first and worst impairment on day 15 and 23 respectively. The impaired performance recovered to pretreatment level over one week after drug cessation. In contrast, incremental dosing procedure impaired SDR performance on the first treatment day, which recovered within treatment period.

CONCLUSION

Results suggested increase of SDR deficit severity by repeated PCP administrations, whereas the incremental dosing procedure did not increase SDR deficit severity and duration.

Diurnal cortisol variation and cortisol response to an MRI stressor in schizophrenia and bipolar disorder

Markers of HPA axis function, including diurnal cortisol rhythm and cortisol responses to stress or pharmacological manipulation, are increasingly reported as disrupted in schizophrenia (SZ) and bipolar disorder (BD). However, there has been no direct comparison of cortisol responses to stress in SZ and BD in the same study, and associations between cortisol dysfunction and illness characteristics remain unclear. In this study we used spline embedded linear mixed models to examine cortisol levels of SZ and BD participants at waking, during the first 45min after waking (representing the cortisol awakening response; CAR), during the period of rapid cortisol decline post the awakening response, and in reaction to a stressor (MRI scan), relative to healthy controls (HC). Contrary to expectations, neither SZ nor BD showed differences in waking cortisol levels, CAR, or immediate post-CAR decline compared to HC; however, waking cortisol levels were greater in BD relative to SZ. In response to the MRI stressor, the SZ group showed a significant absence of the expected increase in cortisol responsivity to stress, which was seen in both the BD and HC groups. Clinical factors affecting the CAR differed between SZ and BD. In SZ, higher antipsychotic medication dosage was associated with a steeper incline of the CAR, while greater positive symptom severity was associated with a more blunted CAR, and greater levels of anxiety were associated with the blunted cortisol response to stress. In BD, longer illness duration was associated with a steeper incline in CAR and lower levels of waking cortisol. These results suggest that cortisol responses may normalize with medication (in SZ) and longer illness duration (in BD), in line with findings of aberrant cortisol levels in the early stages of psychotic disorders.