Document Detail

Stress, the hippocampus and the hypothalamic-pituitary-adrenal axis: implications for the development of psychotic disorders.
MedLine Citation:
PMID:  16911747     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The experience of stress is commonly implicated in models of the onset of psychotic disorders. However, prospective studies investigating associations between biological markers of stress and the emergence of psychotic disorders are limited and inconclusive. One biological system proposed as the link between the psychological experience of stress and the development of psychosis is the Hypothalamic-Pituitary-Adrenal (HPA) axis. This paper summarizes and discusses evidence supporting a role for HPA-axis dysfunction in the early phase of schizophrenia and related disorders. METHOD: A selective review of psychiatric and psychological research on stress, coping, HPA-axis, the hippocampus and psychotic disorders was performed, with a particular focus on the relationship between HPA-axis dysfunction and the onset of psychotic disorders. RESULTS: Individual strands of past research have suggested that the HPA-axis is dysfunctional in at least some individuals with established psychotic disorders; that the hippocampus is an area of the brain that appears to be implicated in the onset and maintenance of psychotic disorders; and that an increase in the experience of stress precedes the onset of a psychotic episode in some individuals. Models of the onset and maintenance of psychotic disorders that link these individual strands of research and strategies for examining these models are proposed in this paper. CONCLUSIONS: The current literature provides some evidence that the onset of psychotic disorders may be associated with a higher rate of stress and changes to the hippocampus. It is suggested that future research should investigate whether a relationship exists between psychological stress, HPA-axis functioning and the hippocampus in the onset of these disorders. Longitudinal assessment of these factors in young people at 'ultra' high risk of psychosis and first-episode psychosis cohorts may enhance understanding of the possible interaction between them in the early phases of illness.
Lisa J Phillips; Patrick D McGorry; Belinda Garner; Katherine N Thompson; Christos Pantelis; Stephen J Wood; Gregor Berger
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Australian and New Zealand journal of psychiatry     Volume:  40     ISSN:  0004-8674     ISO Abbreviation:  Aust N Z J Psychiatry     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-16     Completed Date:  2006-12-20     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0111052     Medline TA:  Aust N Z J Psychiatry     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  725-41     Citation Subset:  IM    
Department of Psychology, University of Melbourne, Parkville, Victoria, Australia.
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MeSH Terms
Hippocampus / physiopathology*
Hypothalamo-Hypophyseal System / physiopathology*
Models, Biological
Pituitary-Adrenal System / physiopathology*
Psychotic Disorders / etiology*
Review Literature as Topic
Stress, Physiological / pathology*,  psychology
Comment In:
Aust N Z J Psychiatry. 2006 Sep;40(9):722-4   [PMID:  16911746 ]

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