Cortisol and dehydroepiandrosterone-sulphate levels correlate with symptom severity in first-episode psychosis

Garner, Belinda, Phassouliotis, Christina, Phillips, Lisa J., Markulev, Connie, Butselaar, Felicity, Bendall, Sarah, Yun, Yang, & McGorry, Patrick D. (2011) Cortisol and dehydroepiandrosterone-sulphate levels correlate with symptom severity in first-episode psychosis. Journal of Psychiatric Research, 45(2), pp. 249-255.

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Dehydroepiandrosterone (DHEA) and its sulphate form (DHEA) are neuroactive steroids with antiglucocorticoid properties. An imbalance in the ratio of cortisol to DHEA(S) has been implicated in the pathophysiology of stress-related psychiatric disorders. This study prospectively investigated circulating cortisol, DHEAS and their ratio in first-episode psychosis (FEP) patients compared to healthy controls, and their relationship to perceived stress, psychotic, negative and mood symptoms.


Blood cortisol and DHEAS levels were obtained in 39 neuroleptic-naïve or minimally-treated FEP patients and 25 controls. Twenty-three patients and 15 controls received repeat assessments after 12 weeks. Perceived stress was assessed using the Perceived Stress Scale and symptoms were assessed in patients using standard rating scales.


At baseline, no differences were observed in cortisol, DHEAS or the cortisol/DHEAS ratio between patients and controls. There were also no group differences in the change in these biological variables during the study period. Within FEP patients, decreases in cortisol and the cortisol/DHEAS ratio over time were directly related to the improvement in depression (r = 0.45; p = 0.031, r = 0.52; p = 0.01), negative (r = 0.51; p = 0.006, r = 0.55; p = 0.008) and psychotic symptoms (cortisol only, r = 0.53; p = 0.01). Perceived stress significantly correlated with DHEAS (r = 0.51; p = 0.019) and the cortisol/DHEAS ratio (r = -0.49; p = 0.024) in controls, but not patients, possibly reflecting an impaired hormonal response to stress in FEP patients.


These findings further support the involvement of the stress system in the pathophysiology of psychotic disorders, with implications for treatment strategies that modulate these neurosteroids.

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ID Code: 84456
Item Type: Journal Article
Refereed: Yes
Keywords: first-episode psychosis, cortisol, dehydroepiandrosterone, DHEAS, depression
DOI: 10.1016/j.jpsychires.2010.06.008
ISSN: 0022-3956
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Psychiatry (incl. Psychotherapy) (110319)
Divisions: Current > Schools > School of Clinical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2011 Elsevier
Copyright Statement: This is the author’s version of a work that was accepted for publication in Journal of Psychiatric Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Psychiatric Research, [VOL 45, ISSUE 2, (2015)] DOI: 10.1016/j.jpsychires.2010.06.008
Deposited On: 25 May 2015 23:30
Last Modified: 03 Jun 2015 04:51

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