Dehydroepiandrosterone sulfate (DEHA-S), cortisol and adrenocorticotropic hormone (ACTH) levels in drug-naive, first episode patients with psychosis

P Petrikis,S Tigas,S Brikos,M Christou,T Hyphantis,G Georgiou,A Karampas

doi:10.1192/j.eurpsy.2021.2137

Abstract

IntroductionImpaired response to stress and a pathological activation of the hypothalamic-pituitary-adrenal axis have been implicated in the pathophysiology of schizophreniaObjectivesTo measure serum ACTH, cortisol and DEHA-S levels in drug-naïve, first-episode patients with psychosis.MethodsResults are reported as mean (standard deviation, range). Paired t-test or Wilcoxon signed rank test were performed for group comparisons. The level of significance was set at p-value<0.05. Statistical analysis was performed with Stata 15.1.ResultsData were included for 110 subjects (70 men, 40 women); 55 patients and 55 controls matched for age and sex. Mean age was 31.3 years (8.7, 18-48) in patients and 31.4 years (8.9, 17-49) in controls. Serum cortisol and Cortisol/DHEA-S ratio were statistically significantly lower in patients [12.6μg/dl (4.5, 3.5-24.5) and 5.3 (3.6, 1.3-19.5), respectively] compared to controls [15.5 μg/dl (4.9, 4.2-30.1) and 8 (4.7, 1.1-25.5), respectively] (p-value=0.0068 and 0.0005, respectively). Additionally, serum DHEA-S was statistically significantly higher in patients [306.5 μg/dl(165.4, 70-790)] compared to controls [240.1 μg/dl(113.5, 46-597)] (p-value=0.0114). ACTH was also higher in patients [28.5 pg/ml(15.7, 6.2-73.9)] than controls [26.5 pg/ml (15.3, 7-70.5)] but this difference wasn’t statistically significant (p-value=0.6359).ConclusionsWe report elevated DEHA-S, decreased cortisol levels and decreased cortisol/DEHA-S ratio in the patients’ compared to the controls’ group.DisclosureNo significant relationships.

Highlights

Yoga may pose a promising complementary therapy in the multimodal treatment of schizophrenia spectrum disorders (SSD)
Twenty-five semi-structured interviews were conducted with in-patients with SSD after they participated in a Yoga-based group therapy (YBGT) session
Future research should examine to what extent these effects can be sustained and how the mindful approach during YBGT can be transferred to areas outside the Yoga class

Summary

Introduction

Psychosis in Alzheimer’s disease has an incidence of ~ 10% per year. Objectives: To study a case of Alzheimer’s disease presenting psychotic symptoms Methods: Retrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology. Results: A 40-year-old goes to the emergency room due to heteroaggression at home. Provisional diagnosis of acute psychotic episode made and low dose risperidone was prescribed. During his stay on the hospital Ward, sedation, recent memory alterations, spatiotemporal disorientation lack of initiative and disorganized behaviors appear. His mother died of Alzheimer’s disease with 36 years-old and another affected brother with 42 yeras-old. The definitive diagnosis is Alzheimer’s disease and genetic studies are currently being carried out.