Objectives: We review studies of whether cortisol levels following psychosocial stress exposure differ between patients with psychosis and healthy control subjects.
Methods: Original research published between 1993 and February 2019 was included in the literature search. Studies that used experimentally induced psychosocial stress and reported stress response measures of plasma or saliva cortisol levels in patients at any stage of illness (i.e. high risk, first episode and chronic phase) were included.
Results: A total of 17 studies were included. Although there was evidence of inconsistencies in measures, we observed moderate evidence of an association with stress-induced cortisol blunting response across studies.
Conclusions: This review highlights recent evidence of blunting of cortisol response following experimentally induced psychosocial stress. While there was some evidence of this blunted response across illness types and stages, the strongest evidence was observed for those with chronic schizophrenia. Due to the low number of studies, in particular in bipolar disorder, much work is still needed to accurately characterise the biological effects of stress in psychosis.
|Number of pages||11|
|Journal||Irish Journal of Psychological Medicine|
|Early online date||18 Jul 2019|
|Publication status||Published - Dec 2019|
Bibliographical noteFunding Information:
This work was supported by the European Research Council (GD, ERC-2015-STG-677467) and Science Foundation Ireland (GD, SFI-16/ERCS/3787).
© 2019 College of Psychiatrists of Ireland.
- Bipolar disorder
- HPA axis
- stress reactivity
- stress response
ASJC Scopus subject areas
- Applied Psychology
- Psychiatry and Mental health
- History and Philosophy of Science