Altered systemic cortisol metabolism in bipolar disorder and schizophrenia spectrum disorders
Abstract Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis is suggested as a pathophysiological factor in bipolar disorder and schizophrenia. Increased clearance of cortisol was recently indicated as a component in the HPA axis hyperdrive. The aim of the present study was to test the mode...
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| Veröffentlicht in: | Journal of psychiatric research 2014-05, Vol.52, p.57-62 |
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| creator | Steen, Nils Eiel Methlie, Paal Lorentzen, Steinar Dieset, Ingrid Aas, Monica Nerhus, Mari Haram, Marit Agartz, Ingrid Melle, Ingrid Berg, Jens P Andreassen, Ole A |
| description | Abstract Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis is suggested as a pathophysiological factor in bipolar disorder and schizophrenia. Increased clearance of cortisol was recently indicated as a component in the HPA axis hyperdrive. The aim of the present study was to test the model of increased cortisol metabolism in a new replication sample separately and combined with a previously published sample of bipolar disorder and schizophrenia. Spot urine was sampled from 212 healthy controls (HC) and 221 patients with a schizophrenia spectrum disorder (SCZ, n = 115) and bipolar disorder (BD, n = 106). Of these, a subsample of 169 HC and 155 patients was included in a previous report. Urinary free cortisol, cortisone and their metabolites were measured, and the activities of 5α-reductase, 5β-reductase and 11β-HSD were estimated and analyzed for differences between groups. In the new sample, there was increased enzyme activity in SCZ for 5β-reductase ( p = 0.024 vs HC; p = 0.027 vs BD) and 11β-HSD2 ( p = 0.014 vs HC; p = 0.004 vs BD). In the combined sample, there was increased activity in SCZ for 5α-reductase ( p |
| doi_str_mv | 10.1016/j.jpsychires.2014.01.017 |
| format | Article |
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Increased clearance of cortisol was recently indicated as a component in the HPA axis hyperdrive. The aim of the present study was to test the model of increased cortisol metabolism in a new replication sample separately and combined with a previously published sample of bipolar disorder and schizophrenia. Spot urine was sampled from 212 healthy controls (HC) and 221 patients with a schizophrenia spectrum disorder (SCZ, n = 115) and bipolar disorder (BD, n = 106). Of these, a subsample of 169 HC and 155 patients was included in a previous report. Urinary free cortisol, cortisone and their metabolites were measured, and the activities of 5α-reductase, 5β-reductase and 11β-HSD were estimated and analyzed for differences between groups. In the new sample, there was increased enzyme activity in SCZ for 5β-reductase ( p = 0.024 vs HC; p = 0.027 vs BD) and 11β-HSD2 ( p = 0.014 vs HC; p = 0.004 vs BD). In the combined sample, there was increased activity in SCZ for 5α-reductase ( p < 0.001 vs HC; p = 0.020 vs BD), 5β-reductase ( p < 0.001 vs HC; p = 0.045 vs BD) and 11β-HSD2 ( p < 0.001 vs HC; p = 0.043 vs BD), and in BD for 5β-reductase ( p = 0.002), 11β-HSD2 ( p = 0.039) and 5α-reductase (trend, p = 0.084) (all vs HC). The findings confirm increased systemic cortisol metabolism in BD and SCZ. This is most consistent in SCZ, with BD taking an intermediate position. The design makes it impossible to determine the direction of the effect. However, the findings merit further study of cortisol metabolism as a possible component in the HPA axis dysfunction and pathophysiology of BD and SCZ.</description><identifier>ISSN: 0022-3956</identifier><identifier>EISSN: 1879-1379</identifier><identifier>DOI: 10.1016/j.jpsychires.2014.01.017</identifier><identifier>PMID: 24534618</identifier><identifier>CODEN: JPYRA3</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>11β-Hydroxysteroid dehydrogenase ; 5α reductase ; 5β reductase ; Adolescent ; Adult ; Adult and adolescent clinical studies ; Analysis of Variance ; Biological and medical sciences ; Bipolar affective disorder ; Bipolar Disorder - metabolism ; Bipolar disorders ; Cortisol ; Dysfunction ; Female ; General aspects ; Humans ; Hydrocortisone - metabolism ; Hypothalamic-pituitary-adrenal-axis ; Male ; Medical sciences ; Metabolism ; Middle Aged ; Miscellaneous ; Mood disorders ; Psychiatric Status Rating Scales ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychoses ; Psychosis ; Schizophrenia ; Schizophrenia - metabolism ; Severe mental disorders ; Tetrahydrocortisol - analogs & derivatives ; Tetrahydrocortisol - metabolism ; Tetrahydrocortisone - metabolism ; Urine tests ; Young Adult</subject><ispartof>Journal of psychiatric research, 2014-05, Vol.52, p.57-62</ispartof><rights>Elsevier Ltd</rights><rights>2014 Elsevier Ltd</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2014 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c558t-5e68ec716683d35eae0e5c26dbc5b626953189aef11ee3e9ee73bfdd924d6c8e3</citedby><cites>FETCH-LOGICAL-c558t-5e68ec716683d35eae0e5c26dbc5b626953189aef11ee3e9ee73bfdd924d6c8e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpsychires.2014.01.017$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,782,786,3554,27933,27934,31009,46004</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28306570$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24534618$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Steen, Nils Eiel</creatorcontrib><creatorcontrib>Methlie, Paal</creatorcontrib><creatorcontrib>Lorentzen, Steinar</creatorcontrib><creatorcontrib>Dieset, Ingrid</creatorcontrib><creatorcontrib>Aas, Monica</creatorcontrib><creatorcontrib>Nerhus, Mari</creatorcontrib><creatorcontrib>Haram, Marit</creatorcontrib><creatorcontrib>Agartz, Ingrid</creatorcontrib><creatorcontrib>Melle, Ingrid</creatorcontrib><creatorcontrib>Berg, Jens P</creatorcontrib><creatorcontrib>Andreassen, Ole A</creatorcontrib><title>Altered systemic cortisol metabolism in bipolar disorder and schizophrenia spectrum disorders</title><title>Journal of psychiatric research</title><addtitle>J Psychiatr Res</addtitle><description>Abstract Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis is suggested as a pathophysiological factor in bipolar disorder and schizophrenia. Increased clearance of cortisol was recently indicated as a component in the HPA axis hyperdrive. The aim of the present study was to test the model of increased cortisol metabolism in a new replication sample separately and combined with a previously published sample of bipolar disorder and schizophrenia. Spot urine was sampled from 212 healthy controls (HC) and 221 patients with a schizophrenia spectrum disorder (SCZ, n = 115) and bipolar disorder (BD, n = 106). Of these, a subsample of 169 HC and 155 patients was included in a previous report. Urinary free cortisol, cortisone and their metabolites were measured, and the activities of 5α-reductase, 5β-reductase and 11β-HSD were estimated and analyzed for differences between groups. In the new sample, there was increased enzyme activity in SCZ for 5β-reductase ( p = 0.024 vs HC; p = 0.027 vs BD) and 11β-HSD2 ( p = 0.014 vs HC; p = 0.004 vs BD). In the combined sample, there was increased activity in SCZ for 5α-reductase ( p < 0.001 vs HC; p = 0.020 vs BD), 5β-reductase ( p < 0.001 vs HC; p = 0.045 vs BD) and 11β-HSD2 ( p < 0.001 vs HC; p = 0.043 vs BD), and in BD for 5β-reductase ( p = 0.002), 11β-HSD2 ( p = 0.039) and 5α-reductase (trend, p = 0.084) (all vs HC). The findings confirm increased systemic cortisol metabolism in BD and SCZ. This is most consistent in SCZ, with BD taking an intermediate position. The design makes it impossible to determine the direction of the effect. However, the findings merit further study of cortisol metabolism as a possible component in the HPA axis dysfunction and pathophysiology of BD and SCZ.</description><subject>11β-Hydroxysteroid dehydrogenase</subject><subject>5α reductase</subject><subject>5β reductase</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Bipolar affective disorder</subject><subject>Bipolar Disorder - metabolism</subject><subject>Bipolar disorders</subject><subject>Cortisol</subject><subject>Dysfunction</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Hydrocortisone - metabolism</subject><subject>Hypothalamic-pituitary-adrenal-axis</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mood disorders</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychiatry</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychoses</subject><subject>Psychosis</subject><subject>Schizophrenia</subject><subject>Schizophrenia - metabolism</subject><subject>Severe mental disorders</subject><subject>Tetrahydrocortisol - analogs & derivatives</subject><subject>Tetrahydrocortisol - metabolism</subject><subject>Tetrahydrocortisone - metabolism</subject><subject>Urine tests</subject><subject>Young Adult</subject><issn>0022-3956</issn><issn>1879-1379</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkk2LFDEQhhtR3NnVvyB9EbzMmEo6XxdhXXQVFjyoRwnppIbN2F-muoXx15thxl3wNFCQQ563qqj3raoa2AYYqLe7zW6ifbhPGWnDGTQbBqX0k2oFRts1CG2fVivGOF8LK9VFdUm0Y4xpDs3z6oI3UjQKzKr6cd3NmDHWtKcZ-xTqMOY50djVPc6-HbtEfZ2Guk3T2Plcx_KXI-baD0VUVvgzTvcZh-RrmjDMeekfGHpRPdv6jvDl6b2qvn_88O3m0_ruy-3nm-u7dZDSzGuJymDQoJQRUUj0yFAGrmIbZKu4slKAsR63AIgCLaIW7TZGy5uogkFxVb059p3y-GtBml2fKGDX-QHHhRzIBqyRmskzUNEY0QAzZ6CcCQOWqzNQprW1WoqCmiMa8kiUceumnHqf9w6YO7jrdu7RXXdw1zEopYv01WnK0vYYH4T_7CzA6xPgKfhum_0QEj1yRjBVrlC490cOiym_E2ZHIeEQMJaZYXZxTOds8-6_JqFLQypzf-IeaTcueSimO3DEHXNfD2k8hBGaEkSumPgLAiLeGg</recordid><startdate>20140501</startdate><enddate>20140501</enddate><creator>Steen, Nils Eiel</creator><creator>Methlie, Paal</creator><creator>Lorentzen, Steinar</creator><creator>Dieset, Ingrid</creator><creator>Aas, Monica</creator><creator>Nerhus, Mari</creator><creator>Haram, Marit</creator><creator>Agartz, Ingrid</creator><creator>Melle, Ingrid</creator><creator>Berg, Jens P</creator><creator>Andreassen, Ole A</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7TK</scope><scope>7QJ</scope></search><sort><creationdate>20140501</creationdate><title>Altered systemic cortisol metabolism in bipolar disorder and schizophrenia spectrum disorders</title><author>Steen, Nils Eiel ; Methlie, Paal ; Lorentzen, Steinar ; Dieset, Ingrid ; Aas, Monica ; Nerhus, Mari ; Haram, Marit ; Agartz, Ingrid ; Melle, Ingrid ; Berg, Jens P ; Andreassen, Ole A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c558t-5e68ec716683d35eae0e5c26dbc5b626953189aef11ee3e9ee73bfdd924d6c8e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>11β-Hydroxysteroid dehydrogenase</topic><topic>5α reductase</topic><topic>5β reductase</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Bipolar affective disorder</topic><topic>Bipolar Disorder - metabolism</topic><topic>Bipolar disorders</topic><topic>Cortisol</topic><topic>Dysfunction</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Hydrocortisone - metabolism</topic><topic>Hypothalamic-pituitary-adrenal-axis</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mood disorders</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychiatry</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. 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Increased clearance of cortisol was recently indicated as a component in the HPA axis hyperdrive. The aim of the present study was to test the model of increased cortisol metabolism in a new replication sample separately and combined with a previously published sample of bipolar disorder and schizophrenia. Spot urine was sampled from 212 healthy controls (HC) and 221 patients with a schizophrenia spectrum disorder (SCZ, n = 115) and bipolar disorder (BD, n = 106). Of these, a subsample of 169 HC and 155 patients was included in a previous report. Urinary free cortisol, cortisone and their metabolites were measured, and the activities of 5α-reductase, 5β-reductase and 11β-HSD were estimated and analyzed for differences between groups. In the new sample, there was increased enzyme activity in SCZ for 5β-reductase ( p = 0.024 vs HC; p = 0.027 vs BD) and 11β-HSD2 ( p = 0.014 vs HC; p = 0.004 vs BD). In the combined sample, there was increased activity in SCZ for 5α-reductase ( p < 0.001 vs HC; p = 0.020 vs BD), 5β-reductase ( p < 0.001 vs HC; p = 0.045 vs BD) and 11β-HSD2 ( p < 0.001 vs HC; p = 0.043 vs BD), and in BD for 5β-reductase ( p = 0.002), 11β-HSD2 ( p = 0.039) and 5α-reductase (trend, p = 0.084) (all vs HC). The findings confirm increased systemic cortisol metabolism in BD and SCZ. This is most consistent in SCZ, with BD taking an intermediate position. The design makes it impossible to determine the direction of the effect. However, the findings merit further study of cortisol metabolism as a possible component in the HPA axis dysfunction and pathophysiology of BD and SCZ.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>24534618</pmid><doi>10.1016/j.jpsychires.2014.01.017</doi><tpages>6</tpages></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Access via ScienceDirect (Elsevier) |
| subjects | 11β-Hydroxysteroid dehydrogenase 5α reductase 5β reductase Adolescent Adult Adult and adolescent clinical studies Analysis of Variance Biological and medical sciences Bipolar affective disorder Bipolar Disorder - metabolism Bipolar disorders Cortisol Dysfunction Female General aspects Humans Hydrocortisone - metabolism Hypothalamic-pituitary-adrenal-axis Male Medical sciences Metabolism Middle Aged Miscellaneous Mood disorders Psychiatric Status Rating Scales Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychoses Psychosis Schizophrenia Schizophrenia - metabolism Severe mental disorders Tetrahydrocortisol - analogs & derivatives Tetrahydrocortisol - metabolism Tetrahydrocortisone - metabolism Urine tests Young Adult |
| title | Altered systemic cortisol metabolism in bipolar disorder and schizophrenia spectrum disorders |
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