TY - JOUR
T1 - Childhood Trauma Is Nominally Associated With Elevated Cortisol Metabolism in Severe Mental Disorder
AU - Aas, Monica
AU - Ueland, Torill
AU - Inova, Amina
AU - Melle, Ingrid
AU - Andreassen, Ole A.
AU - Steen, Nils Eiel
N1 - Funding Information:
We thank the patients who took part in the study and the TOP study group researchers who contributed to the data collection. This study was funded by grants from the South-Eastern Norway Health Authority (#2017060) and the Narsad Young Investigator Award to MA (#22388). The study was also funded by the Research Council of Norway (#22327), the KG Jebsen Stiftelsen.
Publisher Copyright:
© Copyright © 2020 Aas, Ueland, Inova, Melle, Andreassen and Steen.
PY - 2020/5/14
Y1 - 2020/5/14
N2 - Objective: Individuals exposed to childhood trauma display longstanding modifications of the Hypothalamic–Pituitary–Adrenal (HPA) axis, as well as cognitive impairments. Schizophrenia spectrum disorder (SZ) and bipolar disorders (BD) are characterised by higher prevalence of childhood trauma, abnormal HPA axis, and cognitive dysfunction. Elevated cortisol metabolism was recently demonstrated in both disorders. However, it is yet to be established if childhood adversity is associated with cortisol metabolism in this population, and how this may be associated with cognitive function. Methods: One-hundred-and-fourteen participants with a DSM-IV SZ or BD diagnosis took part in the study. Diagnoses were evaluated by the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Estimated cortisol metabolizing activity (5α-reductase and 5β-reductase) was assessed by urinary free cortisol, and metabolites. All patients underwent cognitive assessment and completed the Childhood Trauma Questionnaire. Results: Estimated 5β-reductase activity was elevated in participant with childhood physical abuse (r = 0.26, p = 0.005). After adjusting for age, sex and diagnosis, physical abuse was still nominally associated with elevated 5β-reductase. Moreover, only high 5α-reductase activity was negatively correlated with working memory and executive performance (r = −0.23, p = 0.01; r = −0.19, p = 0.05, respectively), however this disappeared after adjusting for age, sex and diagnosis. Cortisol metabolism did not mediate the association between childhood trauma and cognitive function. Conclusions: Our study indicates that childhood physical abuse is associated with elevated cortisol metabolism (5β-reductase) in adults with a SZ or BD disorder. However, our study did not support cortisol metabolism as a mediator between childhood trauma experiences and cognitive function within these disorders.
AB - Objective: Individuals exposed to childhood trauma display longstanding modifications of the Hypothalamic–Pituitary–Adrenal (HPA) axis, as well as cognitive impairments. Schizophrenia spectrum disorder (SZ) and bipolar disorders (BD) are characterised by higher prevalence of childhood trauma, abnormal HPA axis, and cognitive dysfunction. Elevated cortisol metabolism was recently demonstrated in both disorders. However, it is yet to be established if childhood adversity is associated with cortisol metabolism in this population, and how this may be associated with cognitive function. Methods: One-hundred-and-fourteen participants with a DSM-IV SZ or BD diagnosis took part in the study. Diagnoses were evaluated by the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Estimated cortisol metabolizing activity (5α-reductase and 5β-reductase) was assessed by urinary free cortisol, and metabolites. All patients underwent cognitive assessment and completed the Childhood Trauma Questionnaire. Results: Estimated 5β-reductase activity was elevated in participant with childhood physical abuse (r = 0.26, p = 0.005). After adjusting for age, sex and diagnosis, physical abuse was still nominally associated with elevated 5β-reductase. Moreover, only high 5α-reductase activity was negatively correlated with working memory and executive performance (r = −0.23, p = 0.01; r = −0.19, p = 0.05, respectively), however this disappeared after adjusting for age, sex and diagnosis. Cortisol metabolism did not mediate the association between childhood trauma and cognitive function. Conclusions: Our study indicates that childhood physical abuse is associated with elevated cortisol metabolism (5β-reductase) in adults with a SZ or BD disorder. However, our study did not support cortisol metabolism as a mediator between childhood trauma experiences and cognitive function within these disorders.
KW - bipolar disorders
KW - childhood trauma and adversity
KW - clinical features
KW - cognitive function
KW - cortisol metabolism
KW - schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85085524394&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2020.00391
DO - 10.3389/fpsyt.2020.00391
M3 - Article
AN - SCOPUS:85085524394
SN - 1664-0640
VL - 11
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
M1 - 391
ER -
