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Cognitive functioning, cortisol release, and symptom severity in patients with schizophrenia
D J Walder1, E F Walker, R J Lewine
1Department of Psychology (DJW, EFW), Emory University, Atlanta, Georgia 30322, USA.
Biological Psychiatry
|January 4, 2001
Summary
Elevated cortisol levels in psychotic disorders correlate with poorer memory and executive function, and increased symptom severity. This suggests hypothalamic-pituitary-adrenal axis and hippocampal system abnormalities contribute to cognitive deficits and symptoms.
Area of Science:
- Neuroscience
- Psychiatry
- Endocrinology
Background:
- Schizophrenia and psychotic disorders exhibit cortisol dysregulation, hippocampal abnormalities, and memory deficits.
- Cortisol secretion may enhance dopaminergic activity, potentially worsening psychotic symptoms.
Purpose of the Study:
- To investigate the relationship between cortisol release, cognitive performance, and psychotic symptoms.
- To explore the role of the hypothalamic-pituitary-adrenal axis in cognitive function and symptomology.
Main Methods:
- 18 adults with schizophrenia/schizoaffective disorder, 7 with other psychiatric disorders, and 15 controls were studied.
- Cognitive tests (memory, executive function) and salivary cortisol assays were performed.
Main Results:
- Patients with psychotic disorders showed lower cognitive performance compared to controls.
- Across all subjects, higher cortisol levels were linked to poorer memory and frontal task performance.
- In psychotic patients, elevated cortisol correlated with increased positive, disorganized, and overall symptom severity.
Conclusions:
- Abnormalities in the hypothalamic-pituitary-adrenal axis and hippocampus are implicated in cognitive deficits.
- Elevated cortisol secretion in psychotic patients is associated with greater symptom severity.