Pituitary volume reduction in schizophrenia following cognitive behavioural therapy

TY - JOUR

T1 - Pituitary volume reduction in schizophrenia following cognitive behavioural therapy

AU - Premkumar, Preethi

AU - Bream, Danielle

AU - Sapara, Adegboyega

AU - Fannon, Dominic

AU - Anilkumar, Anantha P.

AU - Kuipers, Elizabeth

AU - Kumari, Veena

PY - 2017/4/21

Y1 - 2017/4/21

N2 - Abstract Cognitive behavioural therapy (CBT) for psychosis (CBTp) aims to ower the stress of psychotic symptoms. Given that the pituitary is involved in stress regulation, CBT-led stress reduction may be accompanied by a change in pituitary volume. This study aimed to determine whether CBTp reduces pituitary volume in schizophrenia. The relation between pre-therapy memory and CBTp-led pituitary volume change was also examined given that poor memory relates to a blunted cortisol awakening response, denoting impaired stress response, in schizophrenia. Pituitary volume was measured at baseline in 40 schizophrenia or schizoaffective disorder patients and 30 healthy participants before therapy. Pituitary volume was measured again 6–9 months after patients had either received CBTp in addition to standard care (CBTp + SC, n = 24), or continued with standard care alone (SC, n = 16). CBTp + SC and SC groups were compared on pituitary volume change from baseline to follow-up. Pre-therapy memory performance (Hopkins Verbal Learning and Wechsler Memory Scale – Logical memory) was correlated with baseline-to-follow-up pituitary volume change. Pituitary volume reduced over time in CBTp + SC patients. Additionally, pre-therapy verbal learning correlated more strongly with longitudinal pituitary volume reduction in the CBTp + SC group than the SC group. To conclude, CBTp reduces pituitary volume in schizophrenia most likely by enhancing stress regulation and lowering the distress due to psychotic symptoms.

AB - Abstract Cognitive behavioural therapy (CBT) for psychosis (CBTp) aims to ower the stress of psychotic symptoms. Given that the pituitary is involved in stress regulation, CBT-led stress reduction may be accompanied by a change in pituitary volume. This study aimed to determine whether CBTp reduces pituitary volume in schizophrenia. The relation between pre-therapy memory and CBTp-led pituitary volume change was also examined given that poor memory relates to a blunted cortisol awakening response, denoting impaired stress response, in schizophrenia. Pituitary volume was measured at baseline in 40 schizophrenia or schizoaffective disorder patients and 30 healthy participants before therapy. Pituitary volume was measured again 6–9 months after patients had either received CBTp in addition to standard care (CBTp + SC, n = 24), or continued with standard care alone (SC, n = 16). CBTp + SC and SC groups were compared on pituitary volume change from baseline to follow-up. Pre-therapy memory performance (Hopkins Verbal Learning and Wechsler Memory Scale – Logical memory) was correlated with baseline-to-follow-up pituitary volume change. Pituitary volume reduced over time in CBTp + SC patients. Additionally, pre-therapy verbal learning correlated more strongly with longitudinal pituitary volume reduction in the CBTp + SC group than the SC group. To conclude, CBTp reduces pituitary volume in schizophrenia most likely by enhancing stress regulation and lowering the distress due to psychotic symptoms.

KW - Cognitive behavioural therapy

KW - Hypothalamic pituitary adrenal axis

KW - Memory

KW - Stress regulation

U2 - 10.1016/j.schres.2017.04.035

DO - 10.1016/j.schres.2017.04.035

M3 - Article

SN - 0920-9964

JO - Schizophrenia Research

JF - Schizophrenia Research

ER -