Impact of Environmental Influence and Vulnerability to Stress in the Development of First Psychotic Episode

Abstract

Introduction

Some findings in patients with first psychotic episode (FEP) could be related to alterations of stress responses. Alterations of stress response are reflected in the alterations of the HPA axis.

Objective

To assess the difference in stress response in FEP patients and healthy controls as well as implications of environment to vulnerability to psychosis.

Aim

To assess endocrine and autonomic responses to acute psychosocial stress, their associations with onset of the first psychotic episode as well as the influence of the environmental factors.

Methods

We have assessed clinical status through clinical psychiatric interviews, standardized psychiatric scales and validated psychological scales, (LEQ, WHOQOL-BREF, PBI, Rosenberg) in 45 subjects with FEP and 50 age and gender matched controls. All participants were then exposed to the Trier Social Stress Test (TSTT).

Results

Our preliminary findings on a sample of 95 participants indicate a differences between patients and controls in salivatory cortisol measured in 5 time points during the TSST. Patients with FEP experience more levels of baseline cortisole, and less changes during the stress test then controls. Baseline stress levels indicated in the salivatory cortisole levels correlate with perceived self-esteem, psychological and social quality of life.

Conclusion

Our findings support the alterations of stress response, possibly indicating vulnerability to stress in persons with FEP.

Funding

This work was funded by the grant of the Croatian Science Foundation No UIP-2014-09-1245 Biomarkers in schizophrenia – integration of complementary methods in longitudinal follow up of first episode psychosis patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.