Hypothalamic-Pituitary-Adrenal (HPA) axis Activity in Schizophrenic Patients.

The course and outcome of schizophrenia seem to be influenced by stress and maladaptive coping, yet the process by which stress affects schizophrenia is far less clear. The hypothalamic-pituitary-adrenal (HPA) axis, and in particular the release of glucocorticoids, has been known to play an important role in stress regulation. The purpose of this study was to investigate HPA axis functioning in individuals with schizophrenia. We assessed the salivary cortisol day curve of first-episode schizophrenic inpatients (n = 18) and healthy controls (n = 15). Salivary samples were taken at five different time points during the day. Furthermore, the differences in cortisol levels between schizophrenic patients were related to symptom severity as measured by the Positive and Negative Syndrome Scale (PANSS). Results indicated significantly heightened cortisol levels in schizophrenic patient as compared to controls, although both groups showed a diurnal pattern of cortisol secretion. The area under the curve showed a trend for higher total cortisol secretion in schizophrenic patients. Correlations between ratings on the PANSS subscales and different time points were not significant. Our results provide evidence for a dysregulation of the HPA-axis in schizophrenic patients. Further research is required to determine the relationship between HPA-axis functioning and clinical manifestation of schizophrenia.