Pituitary volume and early treatment response in drug-naïve first-episode psychosis patients

Garner, B., Berger, G.E., Nicolo, J.P., Mackinnon, A., Wood, S.J., Pariante, C.M., Dazzan, P., Proffitt, T.M., Markulev, C., Kerr, M., McConchie, M., Phillips, L.J., Pantelis, C., & McGorry, P.D. (2009) Pituitary volume and early treatment response in drug-naïve first-episode psychosis patients. Schizophrenia Research, 113(1), pp. 65-71.

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Abstract

BACKGROUND:

An early response to antipsychotic treatment in patients with psychosis has been associated with a better course and outcome. However, factors that predict treatment response are not well understood. The onset of schizophrenia and related disorders has been associated with increased levels of stress and hyper-activation of the hypothalamic-pituitary-adrenal (HPA) axis. This study examined whether pituitary volume at the onset of psychosis may be a potential predictor of early treatment response in first-episode psychosis (FEP) patients.

METHODS:

We investigated the relationship between baseline pituitary volume and symptomatic treatment response over 12 weeks using mixed model analysis in a sample of 42 drug-naïve or early treated FEP patients who participated in a controlled dose-finding study of quetiapine fumarate. Logistic regression was used to examine predictors of treatment response. Pituitary volume was measured from magnetic resonance imaging scans that were obtained upon entry into the trial.

RESULTS:

Larger pituitary volume was associated with less improvement in overall psychotic symptoms (Brief Psychiatric Rating Scale (BPRS) P=0.031) and positive symptoms (BPRS positive symptom subscale P=0.010). Regardless of gender, patients with a pituitary volume at the 25th percentile (413 mm(3)) were approximately three times more likely to respond to treatment by week 12 than those at the 75th percentile (635 mm(3)) (odds ratio=3.07, CI: 0.90-10.48).

CONCLUSION:

The association of baseline pituitary volumes with early treatment response highlights the importance of the HPA axis in emerging psychosis. Potential implications for treatment strategies in early psychosis are discussed.

Impact and interest:

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22 citations in Web of Science®

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ID Code: 84465
Item Type: Journal Article
Refereed: Yes
Keywords: pituitary gland, first-episode psychosis, treatment response, magnetic resonance imaging, stress
DOI: 10.1016/j.schres.2009.05.008
ISSN: 09209964
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Psychiatry (incl. Psychotherapy) (110319)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NEUROSCIENCES (110900) > Neurosciences not elsewhere classified (110999)
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: © 2009 Elsevier B.V.
Deposited On: 26 May 2015 03:22
Last Modified: 04 Jun 2015 04:17

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