Document Detail

Neuroendocrine responses to a cold pressor stimulus in polydipsic hyponatremic and in matched schizophrenic patients.
MedLine Citation:
PMID:  17164813     Owner:  NLM     Status:  MEDLINE    
Schizophrenia, many believe, reflects an enhanced vulnerability to psychological stress. Controlled exposure to stressors, however, has produced inconclusive results, particularly with regards to neurohormones. Some of the variability may be attributable to the nature and psychological significance of the stimulus and failure to control physiologic confounds. In addition, it is possible that the heterogeneity of schizophrenia is an important factor. In a carefully designed study and in a controlled setting, we measured the neuroendocrine response of eight polydipsic hyponatremic (PHS), seven polydipsic normonatremic (PNS), and nine nonpolydipsic normonatremic (NNS) (ie normal water balance) schizophrenic in-patients as well as 12 healthy controls (HC) to two different stressors: one of which appears to influence neuroendocrine secretion through its psychological (cold pressor) and the other (upright posture) through its systemic actions. Subjects in the three psychiatric groups were stabilized and acclimated to the research setting, and all received saline to normalize plasma osmolality. Following the cold pressor, plasma adrenocorticotropin and cortisol levels showed a more prolonged rise in PHS patients relative to PNS patients. NNS patients, in contrast, exhibited blunted responses relative to both of the polydipsic groups and the HC. Peak vasopressin responses were also greater in PHS and blunted in NNS patients. Responses to the postural stimulus were similar across patient groups. These findings provide a mechanism for life threatening water intoxication in schizophrenia; help to reconcile conflicting findings of stress responsiveness in schizophrenia; and potentially identify a discrete patient subset with enhanced vulnerability to psychological stress.
Morris B Goldman; Jennifer Gnerlich; Nadeem Hussain
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-12-13
Journal Detail:
Title:  Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology     Volume:  32     ISSN:  0893-133X     ISO Abbreviation:  Neuropsychopharmacology     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-14     Completed Date:  2007-08-31     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  8904907     Medline TA:  Neuropsychopharmacology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1611-21     Citation Subset:  IM    
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MeSH Terms
Cold Temperature / adverse effects
Drinking / physiology
Endocrine System Diseases / blood*,  diagnosis,  physiopathology*
Hyponatremia / blood,  diagnosis,  physiopathology
Hypothalamo-Hypophyseal System / metabolism,  physiopathology,  secretion
Middle Aged
Neurosecretory Systems / physiopathology*
Schizophrenia / blood*,  diagnosis,  physiopathology*
Stress, Psychological / complications*
Thirst / physiology
Vasopressins / metabolism,  secretion
Water Intoxication / etiology,  physiopathology
Water-Electrolyte Imbalance / blood,  diagnosis,  physiopathology
Grant Support
M01 RR00055/RR/NCRR NIH HHS; M01 RR013987/RR/NCRR NIH HHS; M01 RR013987-050031/RR/NCRR NIH HHS; M01-RR-13987/RR/NCRR NIH HHS; R01 MH056525/MH/NIMH NIH HHS; R01 MH056525-01A2/MH/NIMH NIH HHS; R01 MH056525-02/MH/NIMH NIH HHS; R01 MH056525-03/MH/NIMH NIH HHS; R01 MH056525-04/MH/NIMH NIH HHS; R01 MH056525-05/MH/NIMH NIH HHS; R01 MH56525/MH/NIMH NIH HHS
Reg. No./Substance:

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