Dauvermann M R, Donohoe G
School of Psychology, National University of Ireland Galway, University Road, Galway, Ireland.
Ir J Psychol Med. 2019 Dec;36(4):305-315. doi: 10.1017/ipm.2019.27. Epub 2019 Jul 18.
We review studies of whether cortisol levels following psychosocial stress exposure differ between patients with psychosis and healthy control subjects.
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.
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.
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.
我们回顾了关于精神病患者与健康对照者在经历心理社会应激后皮质醇水平是否存在差异的研究。
文献检索纳入了1993年至2019年2月发表的原创性研究。纳入的研究需使用实验诱导的心理社会应激，并报告疾病任何阶段（即高危期、首发期和慢性期）患者血浆或唾液皮质醇水平的应激反应测量值。
共纳入17项研究。尽管有证据表明测量结果存在不一致，但我们在各项研究中观察到中等程度的证据表明与应激诱导的皮质醇钝化反应有关联。
本综述强调了实验诱导的心理社会应激后皮质醇反应钝化的最新证据。虽然在不同疾病类型和阶段都有一些这种钝化反应的证据，但在慢性精神分裂症患者中观察到的证据最为有力。由于研究数量较少，特别是在双相情感障碍方面，仍需要大量工作来准确描述应激在精神病中的生物学效应。
