Elevated hair cortisol is associated with childhood maltreatment and cognitive impairment in schizophrenia and in bipolar disorders

TY - JOUR

T1 - Elevated hair cortisol is associated with childhood maltreatment and cognitive impairment in schizophrenia and in bipolar disorders

AU - Aas, Monica

AU - Pizzagalli, Diego A.

AU - Laskemoen, Jannicke Fjæra

AU - Reponen, Elina J.

AU - Ueland, Torill

AU - Melle, Ingrid

AU - Agartz, Ingrid

AU - Steen, Nils Eiel

AU - Andreassen, Ole A.

N1 - Funding Information: This study was funded by grants from the South-Eastern Norway Regional Health Authority (# 2017060 ), the Research Council of Norway (# 223273 ), and the NARSAD Young Investigator Award to Monica Aas (#22388). Funding Information: We thank the patients who took part in the study as well as NORMENT, which contributedto the data collection. Specific thanks to T B for excellent help in organizing the database. Over the past 3?years, DAP has received consulting fees from Akili Interactive Labs, BlackThorn Therapeutics, Boehringer Ingelheim, Posit Science, and Takeda Pharmaceuticals USA for activities unrelated to the current study. OAA has received speaker's honorarium from Lundbeck. All other authors report no biomedical financial interests. Monica Aas, Diego A Pizzagalli and Ole A Andreassen wrote the first draft. All authors contributed and approved the final version of the manuscript. This study was funded by grants from the South-Eastern Norway Regional Health Authority (#2017060), the Research Council of Norway (#223273), and the NARSAD Young Investigator Award to Monica Aas (#22388). Publisher Copyright: © 2019

PY - 2019/11

Y1 - 2019/11

N2 - Background: The neural diathesis-stress model is useful to understand schizophrenia (SZ) and bipolar (BD) disorders. Childhood maltreatment could affect the Hypothalamic–Pituitary–Adrenal (HPA)-axis and lead to chronic changes in stress-sensitivity, which can be measured with hair cortisol concentrations (HCC), representing long-term, cumulative cortisol levels. Here we investigated if childhood trauma experiences are associated with chronic changes in the HPA axis in severe mental disorders. Methods: Participants with SZ or BD (N = 63) and healthy controls (N = 94) were included, and HCC was measured by ELISA. History of childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ). Global function and symptom levels were obtained using the Global Assessment of Functioning (GAF) Scale and the Positive and Negative Syndrome Scale (PANSS). A neuropsychological test battery (MATRICS) was performed to assess cognitive functions. Results: Our study shows for the first time that patients with a history of childhood maltreatment have higher HCC relative to both healthy controls and patients without a history of childhood maltreatment (P = 0.01, ƞp2 = 0.046). In addition, patients experiencing a mood episode had higher HCC than patients in remission (P = 0.03). Lastly, we are the first to show that patients with higher HCC had poorer cognitive performance, specifically working memory (P = 0.01). All associations were irrespective of diagnostic group. A factor analysis confirmed a subgroup within the patients characterized by childhood maltreatment and elevated HCC. Conclusions: Findings support the neural diathesis-stress model in SZ and BD pointing to long-term changes in HPA-axis following childhood maltreatment experiences.

AB - Background: The neural diathesis-stress model is useful to understand schizophrenia (SZ) and bipolar (BD) disorders. Childhood maltreatment could affect the Hypothalamic–Pituitary–Adrenal (HPA)-axis and lead to chronic changes in stress-sensitivity, which can be measured with hair cortisol concentrations (HCC), representing long-term, cumulative cortisol levels. Here we investigated if childhood trauma experiences are associated with chronic changes in the HPA axis in severe mental disorders. Methods: Participants with SZ or BD (N = 63) and healthy controls (N = 94) were included, and HCC was measured by ELISA. History of childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ). Global function and symptom levels were obtained using the Global Assessment of Functioning (GAF) Scale and the Positive and Negative Syndrome Scale (PANSS). A neuropsychological test battery (MATRICS) was performed to assess cognitive functions. Results: Our study shows for the first time that patients with a history of childhood maltreatment have higher HCC relative to both healthy controls and patients without a history of childhood maltreatment (P = 0.01, ƞp2 = 0.046). In addition, patients experiencing a mood episode had higher HCC than patients in remission (P = 0.03). Lastly, we are the first to show that patients with higher HCC had poorer cognitive performance, specifically working memory (P = 0.01). All associations were irrespective of diagnostic group. A factor analysis confirmed a subgroup within the patients characterized by childhood maltreatment and elevated HCC. Conclusions: Findings support the neural diathesis-stress model in SZ and BD pointing to long-term changes in HPA-axis following childhood maltreatment experiences.

KW - Bipolar disorders

KW - Childhood maltreatment

KW - Clinical characteristics

KW - Cognitive functioning

KW - Hair cortisol concentrations

KW - Schizophrenia

UR - http://www.scopus.com/inward/record.url?scp=85059946449&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2019.01.011

DO - 10.1016/j.schres.2019.01.011

M3 - Article

C2 - 30660575

AN - SCOPUS:85059946449

SN - 0920-9964

VL - 213

SP - 65

EP - 71

JO - Schizophrenia Research

JF - Schizophrenia Research

ER -