Gajsak Linda Rossini, Gelemanovic Andrea, Kuzman Martina Rojnic, Puljak Livia
Department of Biological Psychiatry, Neuropsychiatric Hospital Dr. Ivan Barbot, Jelengradska 1, 44314 Popovaca, Croatia,
Psychiatr Danub. 2017 Mar;29(1):14-23. doi: 10.24869/psyd.2017.14.
To summarize all available evidence from systematic reviews about the impact of stress response in development of first-episode psychosis (FEP) in schizophrenia.
An overview of systematic reviews of any type of primary studies was performed. An electronic search of five databases was conducted in February 2017 (CDSR, DARE, Embase, MEDLINE and PsychINFO). Quality of included systematic reviews was assessed using the AMSTAR checklist.
Eight systematic reviews were included. The main findings of the included reviews point out a possible alteration of the stress response in a subgroup of persons with proneness to psychosis. However, the evidence is limited by the inadequate quality of studies, as well as lack of standardization of outcomes and assessment methods.
Given the heterogeneity of current results, there is no solid evidence for uniform alterations of stress response found in persons with FEP in suggestive of schizophrenia that may serve as a marker of vulnerability to stress and possibly proneness to psychotic state in response to daily hassles.
总结系统评价中关于应激反应在精神分裂症首发精神病（FEP）发生发展中影响的所有现有证据。
对任何类型的原始研究进行系统评价概述。2017年2月对五个数据库（CDSR、DARE、Embase、MEDLINE和PsychINFO）进行了电子检索。使用AMSTAR清单评估纳入的系统评价的质量。
纳入了八项系统评价。纳入评价的主要发现指出，在有精神病倾向的人群亚组中，应激反应可能存在改变。然而，证据受到研究质量不足以及结局和评估方法缺乏标准化的限制。
鉴于当前结果的异质性，没有确凿证据表明FEP患者中存在应激反应的统一改变，提示精神分裂症可能作为对应激易感性的标志物，以及可能对日常烦恼产生精神病状态的倾向。
