Serum cortisol in chronic schizophrenia. A study of the diurnal rhythm in relation to psychiatric mental status

Abstract

18 female, chronically ill schizophrenic patients were evaluated every week over an extended period of time mentally employing the RP-scale after Rockland and Pollin [13]—an evaluation scale for quantifying mental status of psychotic patients. Within the course of 1 week the diurnal variation of serum cortisol was determined for each patient, which meant the determination of serum cortisol levels in the morning (0730), in the afternoon (1530), and in the evening (2130). In 7 patients that were diagnosed as suffering from dementia senilis, corresponding serum cortisol determinations were made. All the patients were receiving seemingly adequate drug therapy. The diurnal variation of serum cortisol was not essentially different in the two groups of patients. A relationship between mental status and the rhythm of serum cortisol existed, involving elevated morning values and a stronger declination of the cortisol diurnal curve in increased mental symptos if these symptoms were of an “out-wardly expressed” character or were associated with anxiety or thought disorder or delusions and paranoid traits. Thus the results implied that there is a relationship between florid schizophrenic symptoms and the activity of the adrenal cortex as is expressed in the diurnal rhythm of serum cortisol.