Yazici Esra, Ogur Yavuz Selim, Erdogan Derya Guzel, Turkmen Betul Aslan, Yazici Ahmet Bulent
Sakarya University Faculty of Medicine, Department of Physiology, Sakarya/Turkey.
Serdivan State Hospital, Department of Psychiatry, Sakarya/Turkey; ORCID 0000-0002-5258-8913
Clin Med Res. 2025 Mar;23(1):11-20. doi: 10.3121/cmr.2025.1930.
This study investigated the relationship between corticotropin-releasing hormone (CRH) related hypothalamic-pituitary-adrenal (HPA) axis hormones, chromogranin (CgA), and the acute stage of schizophrenia. Thirty-eight patients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) were included in the study. Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Stroop Test, Clinical Global Impression Scale (CGI), Global Assessment of Functioning Scale (GAF), and Wechsler Memory Scale III Visual Reproduction Subtest (WMS III-VRS) were implemented to the patient on the days 1 and 20 of their hospitalization. Blood samples were taken on days 1 and 20 from each patient at 8 AM. Adrenocorticotropic hormone (ACTH), cortisol, CRH, and CgA serum levels were measured. The CRH levels were significantly higher on day 20 than day 1 (=0.007, t=-2.8). A positive correlation was found between cortisol level and PANSS General (r=0.325; =0.046) and immediate WMS III- VRS (r=0.424; =0.008). CgA change between the day 1 and day 20 negatively correlated with the sum of previous psychiatric hospitalization days (r=-0.344, =0.034). Day 1 ACTH levels were negatively correlated with the sum of previous psychiatric hospitalization days (r=-0.365, =0.024) and the hospitalization number (r=-0.415, =0.01). HPA axis hormones measured in the acute phase of schizophrenia can give an idea about the severity of the disease and visual memory functions. However, studies with more subjects and controlling confounders are needed.
本研究调查了促肾上腺皮质激素释放激素(CRH)相关的下丘脑-垂体-肾上腺(HPA)轴激素、嗜铬粒蛋白(CgA)与精神分裂症急性期之间的关系。根据《精神疾病诊断与统计手册》第五版(DSM-5)诊断为精神分裂症的38例患者纳入本研究。在患者住院第1天和第20天,对其实施简明精神病评定量表(BPRS)、阳性和阴性症状量表(PANSS)、斯特鲁普测验、临床总体印象量表(CGI)、功能总体评定量表(GAF)以及韦氏记忆量表第三版视觉再现子测验(WMS III-VRS)。在住院第1天和第20天的上午8点,采集每位患者的血样。检测促肾上腺皮质激素(ACTH)、皮质醇、CRH和CgA的血清水平。CRH水平在第20天显著高于第1天(P = 0.007,t = -2.8)。发现皮质醇水平与PANSS总分(r = 0.325;P = 0.046)以及WMS III-VRS即时记忆得分(r = 0.424;P = 0.008)呈正相关。第1天和第20天之间CgA的变化与既往精神科住院天数总和呈负相关(r = -0.344,P = 0.034)。第1天的ACTH水平与既往精神科住院天数总和(r = -0.365,P = 0.024)以及住院次数(r = -0.415,P = 0.01)呈负相关。在精神分裂症急性期检测的HPA轴激素可以反映疾病的严重程度和视觉记忆功能。然而,需要开展更多受试者参与且控制混杂因素的研究。