Thomas Vaessen1,2, Zuzana Kasanova1, Dennis Hernaus3, Johan Lataster2,4, Dina Collip2, Martine van Nierop1, Inez Myin-Germeys1; 1Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Belgium, 2Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands, 3Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA, 4Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands
Objective Results from experimental studies suggest that psychosis and psychosis liability are associated with increased cortisol levels and blunted cortisol reactivity, and that use of antipsychotics may reduce these aberrations. Here, we report on overall cortisol, diurnal slope, and cortisol stress reactivity in everyday life in psychosis and psychosis liability using the experience sampling method (ESM). Methods Our sample consisted of individuals diagnosed with psychotic disorder currently on (MPD; n=53) or off antipsychotic medication (NMPD; n=20), first-degree relatives of psychotic patients (REL; n=47), and healthy controls (HV; n=67). Saliva samples were collected throughout the day on six consecutive days and analyzed for cortisol levels. Simultaneously, stressfulness of the current activity was assessed with ESM questionnaires. Results We found no group differences in overall cortisol level between groups, but REL had a steeper diurnal slope than HV; in MPD a trend was found in the same direction. Regarding reactivity to stressful activities, results indicated attenuation of the cortisol response in both patient groups compared to HV. Conclusion These results do not confirm reports of increased cortisol levels in psychosis, but provide further evidence of stress-related blunting of cortisol and as such contribute to the development of an inclusive biomarker for psychosis.
