Background

In individuals at clinical high-risk for psychosis, elevated cortisol levels predict subsequent onset of psychotic disorder. However, it is unclear whether cortisol alterations are evident at an earlier clinical stage and promote progression of psychosis expression. This study aimed to address this issue by investigating whether cortisol levels in childhood were associated with the emergence of attenuated psychotic symptoms in early adulthood. In exploratory analyses, we examined whether cortisol and psychosocial stress measures interacted in predicting attenuated psychotic symptoms.

Methods

A sample of children (N = 109) enriched for psychosis risk factors were recruited at age 9–12 years and assessed at age 11–14 years (T1) and 17–21 years (T2). Measures of psychopathology, psychosocial stressors, and salivary cortisol were obtained at T1. Attenuated psychotic symptoms were assessed at T2 using the Prodromal Questionnaire.

Results

Diurnal cortisol (β = 0.915, 95% CI: 0.062–1.769) and daily stressors (β = 0.379, 95% CI: 0.034–0.723) at T1 were independently associated with total Prodromal Questionnaire scores at T2 after accounting for demographic factors and T1 psychopathology. Exploratory analyses indicated a significant interaction between T1 diurnal cortisol and daily stressors (β = 0.743, 95% CI: 0.081–1.405), with the highest predicted T2 total Prodromal Questionnaire scores occurring when both diurnal cortisol and daily stressors were increased.

Conclusions

Our findings suggest that daily stressors and elevations in diurnal cortisol in late childhood/early adolescence increases risk for developing attenuated psychotic symptoms. These findings emphasize the importance of assessing environmental and biological risk factors for psychosis during neurodevelopmentally vulnerable time periods.

中文翻译：

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儿童期皮质醇水平与成年早期出现的减轻精神病症状有关

背景

在精神病临床高危人群中，皮质醇水平升高预示着随后会出现精神病。然而，尚不清楚皮质醇改变是否在早期临床阶段明显并促进精神病表达的进展。本研究旨在通过调查儿童时期的皮质醇水平是否与成年早期出现的减轻精神病症状有关来解决这个问题。在探索性分析中，我们检查了皮质醇和心理社会压力测量是否在预测减轻的精神病症状方面相互作用。

方法

 在 9-12 岁时招募了富含精神病风险因素的儿童样本 ( N = 109)，并在 11-14 岁 (T1) 和 17-21 岁 (T2) 进行了评估。在 T1 获得精神病理学、心理社会压力源和唾液皮质醇的测量值。使用前驱问卷在 T2 评估减轻的精神病症状。

结果

T1 的昼夜皮质醇（β = 0.915, 95% CI: 0.062–1.769）和每日压力源（β = 0.379, 95% CI: 0.034–0.723）在考虑人口因素和 T1 后与 T2 的前驱问卷总分独立相关精神病理学。探索性分析表明，T1 昼夜皮质醇和日常压力源之间存在显着的相互作用（β = 0.743, 95% CI：0.081-1.405），当昼夜皮质醇和日常压力源都增加时，T2 总前驱问卷得分最高。

结论

我们的研究结果表明，儿童晚期/青春期早期的日常压力源和昼夜皮质醇水平升高会增加出现轻度精神病症状的风险。这些发现强调了在神经发育脆弱时期评估精神病的环境和生物危险因素的重要性。