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腾讯登录J Psychiatr Res：精神疾病高危青年皮质醇水平增高
| 导读 | 一项来自于《精神病学研究杂志》(<em>Journal of Psychiatric Research</em>)的研究发现：未经治疗的精神疾病临床高危青少年唾液分泌皮质醇浓度明显高于接受治疗者与正常人群。G Sugranyes 和他的研究团队指出，“这一结果支持精神疾病高风险状态患者的下丘脑-垂体-肾上腺轴（HPA）过度激活或（和）神经内分泌异常这一假说，至少在一部分患者... |
一项来自于《精神病学研究杂志》(<em>Journal of Psychiatric Research</em>)的研究发现：未经治疗的精神疾病临床高危青少年唾液分泌皮质醇浓度明显高于接受治疗者与正常人群。G Sugranyes 和他的研究团队指出，“这一结果支持精神疾病高风险状态患者的下丘脑-垂体-肾上腺轴（HPA）过度激活或（和）神经内分泌异常这一假说，至少在一部分患者中是这样的。”
本研究共纳入46位受试者，其中病例组33例，均为精神疾病临床高危患者（CHR），依据前驱症状结构式访谈（SIPS）和前驱症状量表（SOPS）评估其精神症状（阳性症状、阴性症状、情绪和压力敏感性），年龄12~25岁。对照组13例，为与病例组年龄接匹配的健康志愿者。
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CHR组中，12例接受5-羟色胺再摄取抑制剂或（和）抗精神病药物治疗，21例未予治疗。所有受试于中午静坐约30分钟后，取唾液标本，检测其皮质醇水平。病例组检测基线唾液皮质醇浓度与精神症状之间的关系及临床转归。
结果发现：CHR组患者唾液皮质醇水平明显高于正常对照组（2.05ng/mL v1.44 ng/mL），且未予治疗者高于接受精神药物治疗患者（2.31ng/mLv1.59ng/mL）；CHR组中，唾液皮质醇水平与压力敏感性有一定相关趋势，与阳性症状、阴性症状及情绪无明显相关性。
CHR组接受治疗、CHR组未予治疗及对照组三组的唾液皮质醇浓度（ng/mL）比较
G Sugranyes等总结：“精神疾病药物治疗可以促使CHR患者的HPA轴活性趋于正常，可以为前驱症状的治疗提供干预方案”。
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<img src="http://www.bioon.com/biology/UploadFiles/201208/2012081823092247.gif" alt="" width="113" height="149" border="0" hspace="0" />
<a title="" href="http://dx.doi.org/10.1016/j.jpsychires.2012.07.011" target="_blank">doi:10.1016/j.jpsychires.2012.07.011</a>
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<br/><strong>HPA-axis function， symptoms， and medication exposure in youths at clinical high risk for psychosis</strong><br/>
G. Sugranyes, J.L. Thompson
Abstract
Aim
Increased basal cortisol secretion has been associated with heightened clinical risk for psychosis， and among at-risk individuals， has been variably related to positive and mood symptoms， as well as clinical outcome.
Methods
Basal salivary cortisol secretion was assessed in 33 patients at clinical high risk (CHR) for psychosis (21 medication-free and 12 taking a serotonin reuptake inhibitor and/or atypical antipsychotic)， and 13 healthy controls. Among the CHR patients， we also examined associations of basal salivary cortisol with symptoms (positive， negative， mood， stress sensitivity) and clinical outcome.
Results
Basal salivary cortisol secretion was significantly higher in CHR patients who were medication-free compared to CHR patients taking medications and to healthy controls. In this small cohort， basal salivary cortisol secretion was associated at trend level with stress sensitivity， and was not significantly related to other symptoms.
Conclusions
Our finding of elevated basal cortisol secretion in CHR patients supports the premise that excess activation of the HPA axis and/or neuroendocrine abnormalities characterize the psychosis risk state for at least a subset of patients. Our findings further suggest that psychotropic medications may have a normalizing effect on HPA-axis dysfunction in CHR patients， which could potentially inform intervention strategies for the prodrome.
<br/>来源：医脉通
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本研究共纳入46位受试者，其中病例组33例，均为精神疾病临床高危患者（CHR），依据前驱症状结构式访谈（SIPS）和前驱症状量表（SOPS）评估其精神症状（阳性症状、阴性症状、情绪和压力敏感性），年龄12~25岁。对照组13例，为与病例组年龄接匹配的健康志愿者。
<!--more-->
CHR组中，12例接受5-羟色胺再摄取抑制剂或（和）抗精神病药物治疗，21例未予治疗。所有受试于中午静坐约30分钟后，取唾液标本，检测其皮质醇水平。病例组检测基线唾液皮质醇浓度与精神症状之间的关系及临床转归。
结果发现：CHR组患者唾液皮质醇水平明显高于正常对照组（2.05ng/mL v1.44 ng/mL），且未予治疗者高于接受精神药物治疗患者（2.31ng/mLv1.59ng/mL）；CHR组中，唾液皮质醇水平与压力敏感性有一定相关趋势，与阳性症状、阴性症状及情绪无明显相关性。
CHR组接受治疗、CHR组未予治疗及对照组三组的唾液皮质醇浓度（ng/mL）比较
G Sugranyes等总结：“精神疾病药物治疗可以促使CHR患者的HPA轴活性趋于正常，可以为前驱症状的治疗提供干预方案”。
<div id="ztload">
<div>
<div>
<img src="http://www.bioon.com/biology/UploadFiles/201208/2012081823092247.gif" alt="" width="113" height="149" border="0" hspace="0" />
<a title="" href="http://dx.doi.org/10.1016/j.jpsychires.2012.07.011" target="_blank">doi:10.1016/j.jpsychires.2012.07.011</a>
PMC:
PMID:
</div>
<div>
<br/><strong>HPA-axis function， symptoms， and medication exposure in youths at clinical high risk for psychosis</strong><br/>
G. Sugranyes, J.L. Thompson
Abstract
Aim
Increased basal cortisol secretion has been associated with heightened clinical risk for psychosis， and among at-risk individuals， has been variably related to positive and mood symptoms， as well as clinical outcome.
Methods
Basal salivary cortisol secretion was assessed in 33 patients at clinical high risk (CHR) for psychosis (21 medication-free and 12 taking a serotonin reuptake inhibitor and/or atypical antipsychotic)， and 13 healthy controls. Among the CHR patients， we also examined associations of basal salivary cortisol with symptoms (positive， negative， mood， stress sensitivity) and clinical outcome.
Results
Basal salivary cortisol secretion was significantly higher in CHR patients who were medication-free compared to CHR patients taking medications and to healthy controls. In this small cohort， basal salivary cortisol secretion was associated at trend level with stress sensitivity， and was not significantly related to other symptoms.
Conclusions
Our finding of elevated basal cortisol secretion in CHR patients supports the premise that excess activation of the HPA axis and/or neuroendocrine abnormalities characterize the psychosis risk state for at least a subset of patients. Our findings further suggest that psychotropic medications may have a normalizing effect on HPA-axis dysfunction in CHR patients， which could potentially inform intervention strategies for the prodrome.
<br/>来源：医脉通
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</div>
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