Mazure C M, Quinlan D M, Bowers M B
Yale University School of Medicine, Department of Psychiatry, New Haven, Connecticut, USA.
Biol Psychiatry. 1997 Apr 15;41(8):865-70. doi: 10.1016/S0006-3223(96)00222-3.
The association of recent life stressor severity to putative biological markers of stress was examined in 34 newly admitted patients with acute psychosis. Of the biological variables examined, only pretreatment admission serum cortisol was correlated with stressor severity. Pretreatment serum prolactin, plasma homovanillic acid (HVA), and methoxyhydroxyphen-ethylglycol were not associated with severity of recent life stressors. We controlled for clinical and psychosocial variables that might affect the relationship of stressor severity to biological markers, and found that duration of psychotic symptoms was negatively correlated with stressor severity; however, when both cortisol and duration were entered in a stepwise multiple regression analysis, only pretreatment admission cortisol remained significantly and positively correlated with stressor severity. These findings suggest that serum cortisol may be a useful biological marker when investigating the relationship of life stress to episode onset. In addition, pretreatment HVA was correlated with early neuroleptic response but not with stressor severity, suggesting that HVA has value as a predictor of response independent of recent life stressors.
对34名新入院的急性精神病患者，研究了近期生活应激源严重程度与假定的应激生物学标志物之间的关联。在所检测的生物学变量中，仅入院前血清皮质醇与应激源严重程度相关。入院前血清催乳素、血浆高香草酸（HVA）和甲氧基羟基苯乙二醇与近期生活应激源的严重程度无关。我们对可能影响应激源严重程度与生物学标志物关系的临床和社会心理变量进行了控制，发现精神病症状持续时间与应激源严重程度呈负相关；然而，当将皮质醇和持续时间同时纳入逐步多元回归分析时，仅入院前血清皮质醇与应激源严重程度仍保持显著正相关。这些发现表明，在研究生活应激与发病的关系时，血清皮质醇可能是一种有用的生物学标志物。此外，入院前HVA与早期抗精神病药物反应相关，但与应激源严重程度无关，这表明HVA作为反应预测指标的价值独立于近期生活应激源。
