Department of Psychiatry, McGill University, Montreal, Canada.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.
Dev Psychopathol. 2024 May;36(2):774-786. doi: 10.1017/S0954579423000056. Epub 2023 Feb 28.
The stress-vulnerability model has been repeatedly highlighted in relation to the risk, onset and course of psychosis, and has been independently studied in clinical high-risk (CHR) and first-episode psychosis (FEP) populations. Notable in this literature, however, is that there are few studies directly comparing markers of stress response across progressive stages of illness. Here we examined the psychobiological response to the Trier Social Stress Test in 28 CHR (mean age 19.1) and 61 FEP (age 23.0) patients, in order to understand the stage(s) or trajectories in which differences in subjective stress or physiological response occur. The overall clinical sample had greater perceived stress and blunted cortisol (FEP + CHR, = 89, age 21.7) compared with healthy controls ( = 45, age 22.9). Additional analyses demonstrated elevated heart rate and systolic blood pressure in FEP compared with CHR, but there were no further differences in physiological parameters (cortisol, heart rate, or blood pressure) between stage- or trajectory-based groups. Together, this suggests that individual stress response markers may differentially emerge at particular stages to psychosis - and demonstrates how stage-based analyses can shed light on the emergence and evolution of neurobiological changes in mental illness.
压力易损性模型在精神病的风险、发病和病程中反复得到强调，并在临床高风险（CHR）和首发精神病（FEP）人群中进行了独立研究。然而，在这一文献中值得注意的是，很少有研究直接比较疾病进展阶段的应激反应标志物。在这里，我们研究了 28 名 CHR（平均年龄 19.1）和 61 名 FEP（年龄 23.0）患者对特里尔社会应激测试的心理生物学反应，以了解主观应激或生理反应差异发生的阶段或轨迹。与健康对照组（n = 45，年龄 22.9）相比，整个临床样本的感知压力更大，皮质醇水平更低（FEP + CHR，n = 89，年龄 21.7）。进一步的分析表明，与 CHR 相比，FEP 的心率和收缩压升高，但基于阶段或轨迹的组之间的生理参数（皮质醇、心率或血压）没有进一步的差异。综上所述，这表明个体应激反应标志物可能在精神病的特定阶段出现差异，并且表明基于阶段的分析如何阐明精神疾病中神经生物学变化的出现和演变。
